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Bendale YN, Birari‐Gawande P, Patil A, Kadam A. Ayurveda Rasayana Therapy (ART) leads to tumor regression and increased survival in chemo-intolerance high-grade stage IV follicular lymphoma: A case study. Clin Case Rep 2024; 12:e8076. [PMID: 38827936 PMCID: PMC11139640 DOI: 10.1002/ccr3.8076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/03/2023] [Accepted: 10/07/2023] [Indexed: 06/05/2024] Open
Abstract
Key clinical message Ayurveda Rasayana Therapy (ART) may serve as a safe and effective alternative treatment option for chemo-intolerance high-grade stage IV follicular lymphoma patients for increasing survival and tumor regression. Abstract Follicular lymphoma (FL), also called follicle center lymphoma/nodular lymphoma, observed in the B lymphocytes (B-cells). Available therapeutic options for follicular lymphoma are associated with various side effects and, patients with co-morbidities can seldom tolerate the chemotherapy regimens. Rasayana therapy not only resulted in tumor regression and improved survival but also dealt with the adverse effects of previous chemotherapy drugs. Herein, we present a case of a 74-year-old female diagnosed with Follicular lymphoma who had undergone three cycles of chemotherapy with unresolved disease outcome and serious adverse events. The patient refused to undergo further cycles of chemotherapy. Her family decided to start Ayurveda treatment for her as an alternative therapy for cancer care. On thorough case taking considering the Ayurveda parameters personalized Rasayana therapy as planned for the patient with an aim for improvement in Quality of Life (QoL), increasing survival, and optimizing body's immune response to fight the tumor. After treatment of 8 months, this case demonstrated partial tumor response as evidenced by PET-CT-scan. Quality of Life as evaluated using FACT-G was also seen improved besides significant improvement in physical performance status evaluated using ECOG. The patient showed a survival of 3.5 years after starting Ayurveda Rasayana Therapy (ART). Rasayana therapy was well tolerated by the patient. This case report indicates the potential role of ART as a therapeutic option in geriatric cancer patients who are not eligible for cytotoxic interventions. Case warrants further systematic investigation to evaluate the potential role of ART in the treatment of geriatric cancer patients.
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Gong H, Zhou Y, Huang Y, Liao S, Wang Q. Construction of risk prediction model for hyponatremia in patients with acute decompensated heart failure. BMC Cardiovasc Disord 2023; 23:520. [PMID: 37884881 PMCID: PMC10601100 DOI: 10.1186/s12872-023-03557-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 10/11/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Patients with Heart failure (HF) commonly have a water-electrolyte imbalance due to various reasons and mechanisms, and hyponatremia is one of the most common types. However, currently, there are very few local studies on hyponatremia risk assessment in patients with acute decompensated heart failure (ADHF), and there is a lack of specific screening tools. The aim of this study is to identify a prediction model of hyponatremia in patients with acute decompensated heart failure (ADHF) and verify the prediction effect of the model. METHODS A total of 532 patients with ADHF were enrolled from March 2014 to December 2019. Univariate and multivariate logistic regression analyses were performed to investigate the independently associated risk factors of hyponatremia in patients with ADHF. The prediction model of hyponatremia in patients with ADHF was constructed by R software, and validation of the model was performed using the area under the receiver operating characteristic curve (AUC) and calibration curves. RESULTS A total of 65 patients (12.2%) had hyponatremia in patients with ADHF. Multivariate logistic regression analysis demonstrated that NYHA cardiac function classification (NYHA III vs II, OR = 12.31, NYHA IV vs II, OR = 11.55), systolic blood pressure (OR = 0.978), serum urea nitrogen (OR = 1.046) and creatinine (OR = 1.006) were five independent prognostic factors for hyponatremia in patients with ADHF. The AUC was 0.757; The calibration curve was near the ideal curve, which showed that the model can accurately predict the occurrence of hyponatremia in patients with ADHF. CONCLUSIONS The prediction model constructed in our study has good discrimination and accuracy and can be used to predict the occurrence of hyponatremia in patients with ADHF.
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Affiliation(s)
- Huanhuan Gong
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ying Zhou
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yating Huang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shengen Liao
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Qin Wang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Nanna MG, Sutton NR, Kochar A, Rymer JA, Lowenstern AM, Gackenbach G, Hummel SL, Goyal P, Rich MW, Kirkpatrick JN, Krishnaswami A, Alexander KP, Forman DE, Bortnick AE, Batchelor W, Damluji AA. Assessment and Management of Older Adults Undergoing PCI, Part 1: A JACC: Advances Expert Panel. JACC. ADVANCES 2023; 2:100389. [PMID: 37584013 PMCID: PMC10426754 DOI: 10.1016/j.jacadv.2023.100389] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
As the population ages, older adults represent an increasing proportion of patients referred to the cardiac catheterization laboratory. Older adults are the highest-risk group for morbidity and mortality, particularly after complex, high-risk percutaneous coronary interventions. Structured risk assessment plays a key role in differentiating patients who are likely to derive net benefit vs those who have disproportionate risks for harm. Conventional risk assessment tools from national cardiovascular societies typically rely on 3 pillars: 1) cardiovascular risk; 2) physiologic and hemodynamic risk; and 3) anatomic and procedural risks. We propose adding a fourth pillar: geriatric syndromes, as geriatric domains can supersede all other aspects of risk.
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Affiliation(s)
| | - Nadia R. Sutton
- Department of Internal Medicine, Division of Cardiovascular Medicine, Michigan Medicine, Ann Arbor, Michigan, USA
- Department of Internal Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, and Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Ajar Kochar
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Grace Gackenbach
- University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Scott L. Hummel
- University of Michigan School of Medicine and VA Ann Arbor Health System, Ann Arbor, Michigan, USA
| | - Parag Goyal
- Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Michael W. Rich
- Division of Cardiology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - James N. Kirkpatrick
- Division of Cardiology, Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, Washington, USA
| | - Ashok Krishnaswami
- Division of Cardiology, Kaiser Permanente San Jose Medical Center, San Jose, California, USA
| | | | - Daniel E. Forman
- Divisions of Geriatrics and Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- VA Pittsburgh GRECC, Pittsburgh, Pennsylvania, USA
| | - Anna E. Bortnick
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Abdulla A. Damluji
- Inova Center of Outcomes Research, Fairfax, Virginia, USA
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Gu F, Wu H, Jin X, Kong C, Zhao W. Association of red cell distribution width with the risk of 3-month readmission in patients with heart failure: A retrospective cohort study. Front Cardiovasc Med 2023; 10:1123905. [PMID: 36960473 PMCID: PMC10028279 DOI: 10.3389/fcvm.2023.1123905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/16/2023] [Indexed: 03/09/2023] Open
Abstract
Background In recent years, red cell distribution width (RDW) has been found to be associated with the prognosis of patients with heart failure (HF) in Western countries. However, evidence from Asia is limited. We aimed to investigate the relationship between RDW and the risk of 3-month readmission in hospitalized Chinese HF patients. Methods We retrospectively analyzed HF data from the Fourth Hospital of Zigong, Sichuan, China, involving 1,978 patients admitted for HF between December 2016 and June 2019. The independent variable in our study was RDW, and the endpoint was the risk of readmission within 3 months. This study mainly used a multivariable Cox proportional hazards regression analysis. Smoothed curve fitting was then used to assess the dose-response relationship between RDW and the risk of 3-month readmission. Results In the original cohort of 1,978 patients with HF (42% male and 73.1% aged ≥70 years), 495 patients (25.0%) were readmitted within 3 months after discharge. Smoothed curve fitting showed a linear correlation between RDW and the risk of readmission within 3 months. In the multivariable-adjusted model, every 1% increase in RDW was associated with a 9% increased risk of readmission within 3 months (hazard ratio = 1.09, 95% confidence interval: 1.00-1.15; P < 0.005). Conclusions A higher RDW value was significantly associated with a greater risk of 3-months readmission in hospitalized patients with HF.
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Affiliation(s)
- Fang Gu
- Center for Reproductive Medicine, Department of Pediatrics, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, China
| | - Han Wu
- Department of Clinical Laboratory Medicine, Sir Run Run Shaw Hospital Xiasha Campus, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoli Jin
- Center for Reproductive Medicine, Department of Pediatrics, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, China
| | - Cheng Kong
- Department of Neurosurgery, People’s Hospital of Pan’an County, Jinhua, China
- Correspondence: Wenyan Zhao Cheng Kong
| | - Wenyan Zhao
- Center for General Practice Medicine, Department of General Practice Medicine, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, China
- Correspondence: Wenyan Zhao Cheng Kong
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5
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Hamana T, Fujimoto W, Konishi A, Takemoto M, Kuroda K, Yamashita S, Imanishi J, Iwasaki M, Todoroki T, Okuda M, Hayashi T, Otake H, Tanaka H, Shinohara M, Toh R, Hirata KI. Differences in Prognostic Factors among Patients Hospitalized for Heart Failure According to the Age Category: From the KUNIUMI Registry Acute Cohort. Intern Med 2022; 61:3171-3180. [PMID: 36328584 PMCID: PMC9683819 DOI: 10.2169/internalmedicine.9023-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective Previous studies have described several prognostic factors for heart failure (HF); however, these results were derived from registries consisting of conventional age groups, which might not represent the increasingly aging society. The present study explored the prognostic factors for all-cause death in hospitalized patients with HF across different age categories using an acute HF registry that included relatively old patients. Methods From a total of 1,971 consecutive patients with HF, 1,136 patients were enrolled. We divided the patients into 4 groups (≤65, 66-75, 76-85, and >85 years old) to evaluate all-cause death and prognostic factors of all-cause death. Results During the mean follow-up period of 1,038 days, 445 patients (39.2%) had all-cause death. A Kaplan-Meier analysis demonstrated significantly higher incidence of all-cause death in the elderly groups than in the younger groups (log-rank p<0.001). A Cox proportional-hazard regression analysis revealed that the presence of atrial fibrillation [hazard ratio (HR): 23.3, 95% confidence interval (CI): 2.36-231.1, p=0.007] was a notable predictive factor for all-cause death in the ≤65 years old group, whereas the Clinical Frailty Scale score (HR: 1.33, 95% CI: 1.16-1.52, p<0.001) and hypoalbuminemia (HR: 0.49, 95% CI: 0.31-0.78, p=0.003) were predictors in the >85 years old group. Conclusions Atrial fibrillation was a notable predictor of HF in young patients, whereas frailty and low-grade albuminemia were essential predictive factors of HF in elderly patients. With the increasing number of elderly patients with HF, comprehensive multidisciplinary treatment will be necessary.
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Affiliation(s)
- Tomoyo Hamana
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Wataru Fujimoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center, Japan
| | - Akihide Konishi
- Clinical and Translational Research Center, Kobe University Hospital, Japan
| | - Makoto Takemoto
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center, Japan
| | - Koji Kuroda
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center, Japan
| | | | - Junichi Imanishi
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center, Japan
| | - Masamichi Iwasaki
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center, Japan
| | - Takashi Todoroki
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center, Japan
| | - Masanori Okuda
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center, Japan
| | - Takatoshi Hayashi
- Department of Cardiology, Hyogo Prefectural Awaji Medical Center, Japan
| | - Hiromasa Otake
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Hidekazu Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Masakazu Shinohara
- Division of Epidemiology, Kobe University Graduate School of Medicine, Japan
| | - Ryuji Toh
- Division of Evidence-based Laboratory Medicine, Kobe University Graduate School of Medicine, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
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Demir M, Korkmaz A, Demirtas B. The predictive value of precise-dapt score for mortality in patients with acute decompansed heart failure. INTERNATIONAL JOURNAL OF THE CARDIOVASCULAR ACADEMY 2021. [DOI: 10.4103/ijca.ijca_16_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Geriatric assessment for older adults admitted to the emergency department: A systematic review and meta-analysis. Exp Gerontol 2020; 144:111184. [PMID: 33279664 DOI: 10.1016/j.exger.2020.111184] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 11/12/2020] [Accepted: 11/28/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Older adults are the most frequent users of emergency services. Comprehensive geriatric assessment (CGA) can help identify high-risk older adults at an early stage. We conducted a systematic review and meta-analysis to identify and evaluate CGA tools used in the emergency department (ED), analyze their predictive validity for adverse outcomes and recommend tools for this particular situation. METHODS We systematically searched Medline, Web of Science and CENTRAL for eligible articles published in peer-reviewed journals that observed patients ≥65 years admitted to the ED, used at least one assessment tool and reported adverse outcomes of interest. We performed a descriptive analysis and a bivariate meta-analysis of the diagnostic accuracy and predictive validity of the assessment tools for the chosen adverse outcomes. RESULTS 28 eligible studies were included. The pooled sensitivity (95% CI) of the assessment tools for predicting mortality within short (28-90 days) and long (180-365 days) periods after the first ED visit was 0.77 (0.61-0.89) and 0.79 (0.46-0.96), respectively, with specificity (95% CI) values of 0.45 (0.32-0.59) and 0.37 (0.14-0.65). These findings indicate that the tools used in the included studies had modest predictive accuracy for mortality and were more appropriate for identifying individuals at high risk of readmission in the short term than in the long term. CONCLUSIONS Early use of assessment tools in the ED might improve clinical decision making and reduce negative outcomes for older adults.
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Abstract
BACKGROUND Heart failure (HF) is a chronic condition that usually leads to death a few years after diagnosis. Although several clinical factors have been found to be related to increased mortality, less is known about the impact of social context, especially at the end stage of the disease. Knowing about social context is important to properly classify risk and provide holistic management for patients with advanced HF. OBJECTIVE The aim of this study was to determine the impact of social context on mortality in patients with advanced HF. METHODS A retrospective cohort study was conducted using data from clinical records on community-dwelling patients with HF and with New York Heart Association IV functional class living in Catalonia in northeastern Spain. Clinical data, patient dependency for basic activities of daily living, and social assessments were collected between 2010 and 2013. The primary outcome was all-cause mortality. RESULTS Data from 1148 New York Heart Association class IV patients were analyzed. Mean (SD) age was 82 (9.0) years, and 61.7% were women. The mean (SD) follow-up was 18.2 (11.9) months. Mortality occurred in 592 patients. Social risk was identified in 63.6% of the patients, and 9.3% acknowledged having social problems. In the adjusted multivariate model, being male (hazard ratio (HR), 1.82; 95% confidence interval [CI], 1.16-2.83), having high dependency on others for basic activities of daily living (HR, 2.16; 95% CI, 1.21-3.85), and presenting with a social problem (HR, 2.46; 95% CI, 1.22-4.97) were related to an increased risk of mortality. CONCLUSIONS An unfavorable social profile is an independent risk factor for mortality in patients with advanced HF.
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High-level production of N-terminal pro-brain natriuretic peptide, as a calibrant of heart failure diagnosis, in Escherichia coli. Appl Microbiol Biotechnol 2019; 103:4779-4788. [PMID: 31041470 DOI: 10.1007/s00253-019-09826-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 04/01/2019] [Indexed: 01/11/2023]
Abstract
Heart failure (HF) is a coronary disease that affects people worldwide and has a high mortality rate. N-terminal pro-brain natriuretic peptide (NT-proBNP) has been proven to be a useful and accurate biomarker for diagnosing systolic HF. Here, we report a strategy for the high-level production of recombinant (r)NT-proBNP in Escherichia coli. An Fh8 tag with six histidines was fused to the N terminus of NT-proBNP along with the recognition site of tobacco etch virus (TEV) protease; the 6HFh8-NT-proBNP fusion peptide was expressed in flask cultures of E. coli in almost completely soluble form. The peptide was purified by HisTrap affinity chromatography, and the N-terminal tag was cleaved by TEV protease. After a second round of HisTrap affinity chromatography to remove the TEV protease and N-terminal tag, rNT-proBNP was isolated with high purity (≥ 98%) by carboxymethyl cation exchange chromatography. The final yield of purified rNT-proBNP (97.5 mg/l of bacterial culture; 3.25 mg/g of wet cell) was 55-fold higher than that reported in previous studies (0.5-1.75 mg/l of bacterial culture). Furthermore, the high cell density E. coli fed-batch culture enabled high-level production of rNT-proBNP in the order of grams per liter. The purified rNT-proBNP was detected by enzyme-linked immunosorbent assay and chemiluminescence enzyme immunoassay using commercial monoclonal antibodies recognizing different epitopes, showing a linear dose-response relationship in the range of tested concentrations (slope = 3.58 and r2 = 0.995). These results demonstrate the efficiency of our process for mass producing (gram-to-liter level) rNT-proBNP with acceptable analytical performance.
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Xavier SDO, Ferretti-Rebustini REDL. Clinical characteristics of heart failure associated with functional dependence at admission in hospitalized elderly. Rev Lat Am Enfermagem 2019; 27:e3137. [PMID: 31038631 PMCID: PMC6528626 DOI: 10.1590/1518-8345.2869-3137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/16/2018] [Indexed: 01/27/2023] Open
Abstract
Objective to identify which clinical features of heart failure are associated with a
greater chance of functional dependence for the basic activities of daily
living in hospitalized elderly. Method cross-sectional study conducted with elderly hospitalized patients. The
clinical characteristics of heart failure were assessed by self-report,
medical records and scales. Dependency was assessed by the Katz Index. The
Fisher’s Exact Test was used to analyze associations between the nominal
variables, and logistic regression to identify factors associated with
dependence. Results the sample consisted of 191 cases. The prevalence of functional dependence
was 70.2%. Most of the elderly were partially dependent (66.6%). Clinical
characteristics associated with dependence at admission were dyspnea (Odds
Ratio 8.5, Confidence Interval 95% 2.668-27.664, p <0.001), lower limb
edema (Odds Ratio 5.7, 95% Confidence Interval 2.148-15.571, p <0.001);
cough (Odds Ratio 9.0, 95% confidence interval 1.053-76.938, p <0.045);
precordial pain (Odds Ratio 4.5, 95% confidence interval 1.125-18.023, p
<0.033), and pulmonary crackling (Odds Ratio 4.9, 95% Confidence Interval
1.704-14.094, p <0.003). Conclusion functional dependence in admitted elderly patients with heart failure is more
associated with congestive signs and symptoms.
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Melchio R, Rinaldi G, Testa E, Giraudo A, Serraino C, Bracco C, Spadafora L, Falcetta A, Leccardi S, Silvestri A, Fenoglio L. Red cell distribution width predicts mid-term prognosis in patients hospitalized with acute heart failure: the RDW in Acute Heart Failure (RE-AHF) study. Intern Emerg Med 2019; 14:239-247. [PMID: 30276661 DOI: 10.1007/s11739-018-1958-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 09/24/2018] [Indexed: 01/09/2023]
Abstract
The aim of the study was to evaluate the prognostic role of red cell distribution width (RDW) in a broad population of patients hospitalized for acute heart failure (AHF). In a retrospective cohort observational study, 451 consecutive patients discharged for AHF were categorized in patients with low RDW (≤ 14.8%) and high RDW (> 14.8%). The rates of death from all causes or of hospital readmission for worsening heart failure and death were determined after a median follow-up of 18 months. The overall population has a median age of 80 years (IQR 72-85), 235 patients (52%) were males. Patients with a higher RDW have more comorbidities and a higher Charlson Index. At follow-up, 200 patients (44%) had died and 247 (54%) had died or were readmitted for HF: in the cohort with low RDW, 70 patients (36.4%) had died, whereas in the cohort with high RDW, 165 patients (63.7%) had died: the unadjusted risk ratio of patients with high RDW was 2.03 (log-rank test: p < 0.0001). In a multivariate Cox regression model, the hazard ratio for death from any cause in the 'high RDW' cohort is 1.73 (95% confidence interval 1.2-2.48; p = 0.003); the RDW adds prognostic information beyond that provided by conventional predictors, including age; etiology of HF; anemia; hyponatremia; estimated glomerular filtration rate; NT-proBNP levels; Charlson comorbidity score, atrial fibrillation, functional status, therapy with renin-angiotensin-aldosterone system inhibitors, beta-blockers. RDW is a powerful marker of worse long-term outcomes in patients with AHF, and its prognostic value is maintained beyond that provided by other well-established risk factors or biomarkers.
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Affiliation(s)
- Remo Melchio
- Department of Internal Medicine, A.O. S. Croce e Carle, Via Antonio Carle 5, 12100, Cuneo, CN, Italy.
| | - Gianluca Rinaldi
- Department of Internal Medicine, A.O. S. Croce e Carle, Via Antonio Carle 5, 12100, Cuneo, CN, Italy
| | - Elisa Testa
- Department of Internal Medicine, A.O. S. Croce e Carle, Via Antonio Carle 5, 12100, Cuneo, CN, Italy
| | - Alessia Giraudo
- Department of Internal Medicine, A.O. S. Croce e Carle, Via Antonio Carle 5, 12100, Cuneo, CN, Italy
| | - Cristina Serraino
- Department of Internal Medicine, A.O. S. Croce e Carle, Via Antonio Carle 5, 12100, Cuneo, CN, Italy
| | - Christian Bracco
- Department of Internal Medicine, A.O. S. Croce e Carle, Via Antonio Carle 5, 12100, Cuneo, CN, Italy
| | - Laura Spadafora
- Department of Internal Medicine, A.O. S. Croce e Carle, Via Antonio Carle 5, 12100, Cuneo, CN, Italy
| | - Andrea Falcetta
- Department of Internal Medicine, A.O. S. Croce e Carle, Via Antonio Carle 5, 12100, Cuneo, CN, Italy
| | - Stefano Leccardi
- Department of Internal Medicine, A.O. S. Croce e Carle, Via Antonio Carle 5, 12100, Cuneo, CN, Italy
| | - Alberto Silvestri
- Department of Internal Medicine, A.O. S. Croce e Carle, Via Antonio Carle 5, 12100, Cuneo, CN, Italy
| | - Luigi Fenoglio
- Department of Internal Medicine, A.O. S. Croce e Carle, Via Antonio Carle 5, 12100, Cuneo, CN, Italy
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Zaninović Jurjević T, Dvornik Š, Kovačić S, Matana Kaštelan Z, Brumini G, Matana A, Zaputović L. A simple prognostic model for assessing in-hospital mortality risk in patients with acutely decompensated heart failure. Acta Clin Belg 2018; 74:102-109. [DOI: 10.1080/17843286.2018.1483562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | - Štefica Dvornik
- Department for Laboratory Diagnostics, Clinical Hospital Centre Rijeka, Rijeka, Croatia
| | - Slavica Kovačić
- Department for Radiology, Clinical Hospital Centre Rijeka, Rijeka, Croatia
| | | | - Gordana Brumini
- Faculty of Health Studies, Department for Basic Medical Sciences University of Rijeka, Rijeka, Croatia
| | - Ante Matana
- Department for Cardiovascular Diseases, Clinical Hospital Centre Rijeka, Rijeka, Croatia
| | - Luka Zaputović
- Department for Cardiovascular Diseases, Clinical Hospital Centre Rijeka, Rijeka, Croatia
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