Predictors of Mortality, Rehospitalization for Syncope and Cardiovascular Events in Patients With Cardiovascular Syncope

Onuki, Tatsuya; Miyake, Shoji; Nakamura, Yuya; Ogawa, Kōichi; Ochi, Akinori; Inokuchi, Kaoru; Kawasaki, Shiro; Onishi, Yuki; Onuma, Yoshimasa; Munetsugu, Yumi; Kikuchi, Miwa; Ito, Hiroyuki; Minoura, Yoshino; Watanabe, Norikazu; Adachi, Taro; Kawamura, Mitsuru; Asano, Taku; Tanno, Kaoru; Kobayashi, Youichi

doi:10.1253/circj.cj-16-1296

Cited by 8 publications

(12 citation statements)

References 17 publications

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“…to 13% at 1year. 7,[9][10][11] In a study of 1516 patients attending hospital in the USA, Getchell et al 9 reported a 1-year mortality rate of 13%, which is similar to that reported in our study. In a Danish nationwide cohort database of over 37,000 healthy patients discharged from the ED with syncope, 10 the 1-year mortality was 1.9% which is lower than that reported in our study.…”

Section: Discussionsupporting

confidence: 89%

“…There has been significant variability in the reported mortality risk of patients attending hospital with syncope, ranging from 1.9% to 13% at 1year 7,9‐11 . In a study of 1516 patients attending hospital in the USA, Getchell et al 9 reported a 1‐year mortality rate of 13%, which is similar to that reported in our study.…”

Section: Discussionsupporting

confidence: 82%

“…We found syncope which is similar to previously published literature. 11,13 We found that same-day discharge was independently associated with reduced 1-year mortality which is in keeping with prior studies demonstrating a worse outcome in patients requiring hospital admission following syncope compared with those discharged in the ED.…”

Section: F I G U R Esupporting

confidence: 89%

“…3,4,8 The reported mortality risk following syncope admission is highly variable, ranging from 1.9% to 13% at 1 year. 7,[9][10][11] Numerous risk scores have been developed to help identify patients at higher risk and guide decisions regarding hospital admission versus outpatient investigation. 1 Traditional risk factors associated with increased mortality risk include older age, the presence of heart failure (HF), structural heart disease, comorbidities, and electrocardiogram (ECG) abnormalities.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Impact of a Nurse‐Led Syncope Clinic: Experience from a single UK tertiary center

Adlan

Eftekhari

Paul

et al. 2020

Journal of Arrhythmia

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 82%

Section: F I G U R Esupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Impact of a Nurse‐Led Syncope Clinic: Experience from a single UK tertiary center

Adlan

Eftekhari

Paul

et al. 2020

Journal of Arrhythmia

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“…Reductions in cardiac contractility can lead to systemic hemodynamic effects such as a drop in systemic arterial blood pressure (hypotension), an increased heart rate, syncope, and loss of blood flow to vital organs. Recent studies suggest that drug-induced orthostatic hypotension is a leading cause of syncope in patients who present with this symptom in the emergency room, and it serves as an independent risk factor for rehospitalization in patients suffering from CV disease (Sarasin et al, 2002; Onuki et al, 2017). Increases in cardiac contractility can be equally problematic clinically, leading to myocardial hypertrophy (if chronic), impaired myocardial energetics, and increased pro-arrhythmic potential.…”

Section: Clinical Relevance Of Changes In Cardiac Contractilitymentioning

confidence: 99%

Considerations for an In Vitro, Cell-Based Testing Platform for Detection of Adverse Drug-Induced Inotropic Effects in Early Drug Development. Part 1: General Considerations for Development of Novel Testing Platforms

et al. 2019

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Drug-induced effects on cardiac contractility can be assessed through the measurement of the maximal rate of pressure increase in the left ventricle (LVdP/dt max ) in conscious animals, and such studies are often conducted at the late stage of preclinical drug development. Detection of such effects earlier in drug research using simpler, in vitro test systems would be a valuable addition to our strategies for identifying the best possible drug development candidates. Thus, testing platforms with reasonably high throughput, and affordable costs would be helpful for early screening purposes. There may also be utility for testing platforms that provide mechanistic information about how a given drug affects cardiac contractility. Finally, there could be in vitro testing platforms that could ultimately contribute to the regulatory safety package of a new drug. The characteristics needed for a successful cell or tissue-based testing platform for cardiac contractility will be dictated by its intended use. In this article, general considerations are presented with the intent of guiding the development of new testing platforms that will find utility in drug research and development. In the following article (part 2), specific aspects of using human-induced stem cell-derived cardiomyocytes for this purpose are addressed.

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Clinical predictors for bradycardia and supraventricular tachycardia necessitating therapy in patients with unexplained syncope monitored by insertable cardiac monitor

Onuki

Miyake

Sugiyama

et al. 2021

Clinical Cardiology

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Background Insertable cardiac monitors (ICMs) improve diagnostic yield in patients with unexplained syncope. The most of cardiac syncope is arrhythmic causes include paroxysmal bradycardia and supraventricular tachycardia (SVT) in patients with unexplained syncope receiving ICM. Predictors for bradycardia and SVT that necessitate therapy in patients with unexplained syncope are not well known. Hypothesis This study aimed to investigate predictors of bradycardia and SVT necessitating therapy in patients with unexplained syncope receiving ICMs. Methods We retrospectively reviewed medical records of consecutive patients who received ICMs to monitor unexplained syncope. We performed Cox's stepwise logistic regression analysis to identify significant independent predictors for bradycardia and SVT. Results One hundred thirty‐two patients received ICMs to monitor unexplained syncope. During the 17‐month follow‐up period, 19 patients (14%) needed pacemaker therapy for bradycardia; 8 patients (6%) received catheter ablation for SVT. The total estimated diagnostic rates were 34% and 48% at 1 and 2 years, respectively. Stepwise logistic regression analysis indicated that syncope during effort (odds ratio [OR] = 3.41; 95% confidence interval [CI], 1.21 to 9.6; p = .02) was an independent predictor for bradycardia. Palpitation before syncope (OR = 9.46; 95% CI, 1.78 to 50.10; p = .008) and history of atrial fibrillation (OR = 10.1; 95% CI, 1.96 to 52.45; p = .006) were identified as significant independent predictors for SVT. Conclusion Syncope during effort, and palpitations or history of atrial fibrillation were independent predictors for bradycardia and for SVT. ICMs are useful devices for diagnosing unexplained syncope.

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Predictors of Mortality, Rehospitalization for Syncope and Cardiovascular Events in Patients With Cardiovascular Syncope

Cited by 8 publications

References 17 publications

The Impact of a Nurse‐Led Syncope Clinic: Experience from a single UK tertiary center

The Impact of a Nurse‐Led Syncope Clinic: Experience from a single UK tertiary center

Considerations for an In Vitro, Cell-Based Testing Platform for Detection of Adverse Drug-Induced Inotropic Effects in Early Drug Development. Part 1: General Considerations for Development of Novel Testing Platforms

Clinical predictors for bradycardia and supraventricular tachycardia necessitating therapy in patients with unexplained syncope monitored by insertable cardiac monitor

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