المؤلفون: Nadeem Kassam, Mzee Ngunga, Mohamed Varwani, Miriam Msunza, Mohamed Jeilan

المصدر: BMC Cardiovascular Disorders, Vol 24, Iss 1, Pp 1-10 (2024)

مصطلحات موضوعية: Acute Conary syndrome, Young, Kenyans, Hospital outcomes, Risk factor profile, Mortality, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Abstract Introduction Acute coronary syndrome (ACS) accounts for coronary artery disease (CAD) –related morbidity and mortality. There has been growing concern about the rising incidence of ACS among young individuals globally both in developed and developing countries, including Sub-Saharan Africa. This group’s phenotypic characteristics; risk factors and clinical outcomes are not well described. contextual and regional studies are necessary to understand the magnitude of ACS among young Individuals and help highlight challenges and opportunities for improved ACS outcomes in the region. The study aimed to describe the demographic and clinical characteristics of young individuals hospitalized with ACS and report on in-hospital outcomes. Methodology This single-center retrospective study was conducted at the Aga Khan University Hospital, Nairobi. Medical records of all young individuals hospitalized with ACS from 30th June 2020 to 1st May 2023 were reviewed. We defined young individuals as 50 years or below. Categorical variables were reported as frequencies and proportions, and compared with Pearson chi- square or Fisher’s exact tests. Continuous variables were reported as means or medians and compared with independent t-tests or Mann-Whitney U tests. P- value

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2261Test

الوصول الحر: https://doaj.org/article/19a0400e8791459c8729afd01466add7Test

المؤلفون: E. V. Konstantinova, Yu. S. Ilin, A. A. Velikotskiy, N. A. Rakhimi, A. A. Bogdanova, A. V. Ploshchenkov

المصدر: Рациональная фармакотерапия в кардиологии, Vol 20, Iss 1, Pp 27-34 (2024)

مصطلحات موضوعية: no-reflow phenomenon, acute coronary syndrome, risk factors, diabetes mellitus, in-hospital outcomes, percutaneous coronary intervention, myocardial ischemia time, Therapeutics. Pharmacology, RM1-950, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Aim. To determine the incidence of the no-reflow phenomenon in patients with acute coronary syndrome (ACS) undergoing primary percutaneous coronary intervention (PCI), and to study factors associated with its occurrence in the daily work of the City Clinical Hospital.Material and methods. Of the 2090 patients with ACS admitted to N. I. Pirogov City Clinical Hospital No.1 in the period from 01.01.2017 to 01.11.2022 there were 2 groups of patients with PCI: group 1 (n=59) included patients with initial antegrade coronary blood flow TIMI 0 and final blood flow TIMI 0-2 (with the no/ slow-reflow phenomenon); Group 2 (n=149) included patients with initial coronary blood flow TIMI 0 and final antegrade coronary blood flow TIMI 3 (without the no/slow-reflow phenomenon).Results. The no-/slow-reflow phenomenon was observed in 2.8% of cases. Patients with no-/slow-reflow phenomenon more frequently had diabetes mellitus (42.4% vs. 22.8%, p=0.003), a history of stroke (12.1% vs. 3.4%, p=0.016), higher Killip class and "pain-to-balloon" time 7 [3; 16] vs. 4 [2.3; 8.25] hours, p=0.004. Binary logistic regression identified "pain-to-balloon" time as the most significant predictor of no-/slow-reflow phenomenon development [Odds Ratio (OR)=1.03; 95% CI: 0.95-0.996; p=0.02] and the proximal level of occlusion in infarct-related coronary artery. The incidence of in-hospital mortality was 6.1 times higher in the no-/slow-reflow group compared to the normal blood flow group [OR=6.102±0.433; 95% CI: 2.614-14.247; p

وصف الملف: electronic resource

العلاقة: https://www.rpcardio.online/jour/article/view/2994Test; https://doaj.org/toc/1819-6446Test; https://doaj.org/toc/2225-3653Test

الوصول الحر: https://doaj.org/article/1ad4002effb9417b84ec1ec6313806a3Test

المؤلفون: Lujing Jiang, JunGuo Jin, Xuyu He, Xiangming Hu, Lan Guo, Guo Chen, Yingling Zhou

المصدر: BMC Cardiovascular Disorders, Vol 24, Iss 1, Pp 1-11 (2024)

مصطلحات موضوعية: Uric acid, SUA/Scr, Elderly patients, Acute myocardial infarction, In-hospital outcomes, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Abstract Background The role of Serum uric acid (SUA) in acute myocardial infarction (AMI) was controversial, which might be influenced by the renal clearance function of the patients. The present study aimed to explore the association between serum uric acid to serum creatinine ratio (SUA/Scr), reflecting a net production of SUA, and the in-hospital outcomes of elderly patients with AMI. Methods In this retrospective study, a total of 330 elderly AMI patients (≥ 75 years) were enrolled. Data of SUA and Scr on admission were collected to calculate SUA/Scr ratio. Logistic regression analysis and receiver-operating curves were performed to assess the association between SUA/Scr ratio and in-hospital major adverse cardiovascular events (MACEs) and all-cause death. Results Among the 330 patients, 68 patients had MACEs and 44 patients died. Patients with MACEs or died had lower SUA/Scr values compared with those without MACEs or survival (P

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2261Test

الوصول الحر: https://doaj.org/article/c43779ea1cf94270be05f6dddf363d5fTest

المؤلفون: Jiun-Lin Yan, Wan-Chin Kan, Yi-Hsien Kuo, Mao-Yu Chen, Pin-Yuan Chen, Kuan-Hao Fu

المصدر: Frontiers in Endocrinology, Vol 15 (2024)

مصطلحات موضوعية: metabolic syndrome (MetS), transsphenoidal pituitary surgery, pituitary adenoma, in-hospital outcomes, nationwide inpatient sample (NIS), Diseases of the endocrine glands. Clinical endocrinology, RC648-665

الوصف: IntroductionTranssphenoidal surgery (TSS) is the preferred surgical method for most pituitary adenomas owing to high efficacy and low mortality. This study aimed to evaluate the influence of metabolic syndrome (MetS) on postoperative outcomes of TSS for pituitary adenoma.MethodsThis population-based, retrospective observational study extracted data of adults 20-79 y receiving TSS for pituitary adenoma from the US Nationwide Inpatient Sample (NIS) between 2005-2018. Primary outcomes were pituitary-related complications, poor outcomes (i.e., in-hospital mortality or unfavorable discharge), prolonged length of stay (LOS), and patient safety indicators (PSIs). Univariate and multivariate regressions were performed to determine the associations between study variables and outcomes.Results19,076 patients (representing a 93,185 US in-patient population) were included, among which 2,109 (11.1%) patients had MetS. After adjustment, pre-existing MetS was not significantly associated with presence of pituitary-related complications and poor outcomes. In contrast, MetS was significantly associated with an increased risk for prolonged LOS (adjusted OR (aOR) = 1.19; 95% CI: 1.05-1.34), PSIs (aOR = 1.31; 95% CI: 1.07-1.59) and greater hospital costs (adjusted β = 8.63 thousand USD; 95% CI: 4.98-12.29). Among pituitary-related complications, MetS was independently associated with increased risk of cerebrospinal fluid (CSF) rhinorrhea (aOR = 1.22, 95% CI: 1.01, 1.47) but lowered diabetes insipidus (aOR = 0.83, 95% CI: 0.71, 0.97).DiscussionMetS does not pose excessive risk of in-hospital mortality or unfavorable discharge. However, MetS independently predicted having PSIs, prolonged LOS, greater hospital costs, and CSF rhinorrhea. Study findings may help clinicians achieve better risk stratification before TSS.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fendo.2024.1235441/fullTest; https://doaj.org/toc/1664-2392Test

الوصول الحر: https://doaj.org/article/0e44b5951bd7498aa64e51aee1f7dc54Test

المؤلفون: 宗黎霞1，谷鸿秋2，杨昕2，姜英玉2，李子孝1，2，王春娟1，

المصدر: Zhongguo cuzhong zazhi, Vol 18, Iss 10, Pp 1202-1208 (2023)

مصطلحات موضوعية: 卒中, 静脉溶栓, rt-pa, 尿激酶, 院内结局, stroke, intravenous thrombolysis, urokinase, in-hospital outcomes, Neurology. Diseases of the nervous system, RC346-429

الوصف: 目的 评估我国2016—2022年发病6 h内急性缺血性卒中患者静脉溶栓的变化趋势，并比较rt-PA与尿激酶静脉溶栓的院内临床结局差异。 方法 纳入中国卒中中心联盟（Chinese Stroke Center Alliance，CSCA）2016年1月—2022年12月登记的发病6 h内到院的急性缺血性卒中患者555 991例，计算各年份rt-PA静脉溶栓和尿激酶静脉溶栓的比例变化。采用多因素logistic回归法，以rt-PA溶栓为对照，分析尿激酶溶栓对院内脑梗死出血转化、院内死亡及出院时良好神经功能结局（mRS评分0～1分）的影响。 结果 分别有113 521例和30 950例患者进行了rt-PA和尿激酶静脉溶栓，溶栓率分别为20.42%和5.57%。从2016年至2022年，rt-PA静脉溶栓率从11.26%逐年递增至30.19%，而尿激酶静脉溶栓率则始终波动在较低水平。多因素logistic回归分析显示，与rt-PA静脉溶栓相比，尿激酶静脉溶栓患者发生脑梗死后出血转化（OR 0.740，95%CI 0.662～0.827，P＜0.01）和院内死亡的风险较低（OR 0.820，95%CI 0.764～0.881，P＜0.01），但两组患者出院时良好功能结局率无显著差异（OR 0.989，95%CI 0.951～1.028，P=0.57）。 结论 2016—2022年期间，我国发病6 h内到院的急性缺血性卒中患者rt-PA静脉溶栓率呈逐年增长趋势；尿激酶溶栓后发生脑梗死出血转化风险及院内死亡风险可能低于rt-PA静脉溶栓。 Abstract: Objective To investigate the temporal trend of intravenous thrombolysis in patients with acute ischemic stroke (AIS) who arrived within 6 hours after onset from 2016 to 2022 in China, and compare the risks of in-hospital outcomes between rt-PA and urokinase thrombolysis. Methods A total of 555 991 AIS patients who arrived within 6 hours after onset were enrolled in the Chinese Stroke Center Alliance (CSCA) from January 2016 to December 2022. The rates of rt-PA and urokinase intravenous thrombolysis in AIS patients within 6 hours after onset were calculated respectively of each year. Multivariate logistic regression was used to analyze the risks of hemorrhagic transformation, in-hospital death and good functional outcome at discharge (mRS score 0-1) of urokinase thrombolysis group compared with rt-PA group. Results 113 521 and 30 950 patients were treated with rt-PA and urokinase intravenous thrombolytic therapy respectively. The thrombolysis rates of rt-PA and urokinase were 20.42% and 5.57% respectively. From 2016 to 2022, the rt-PA intravenous thrombolysis rate increased from 11.26% to 30.19%, while the urokinase thrombolysis rate fluctuated at a low level. Multivariate logistic regression analysis showed that compared with rt-PA intravenous thrombolytic therapy, patients with urokinase intravenous thrombolytic therapy had a lower risk of hemorrhagic transformation (OR 0.740, 95%CI 0.662-0.827, P

وصف الملف: electronic resource

العلاقة: http://www.chinastroke.org.cn/CN/article/openArticlePDF.jsp?id=3907Test; https://doaj.org/toc/1673-5765Test

الوصول الحر: https://doaj.org/article/f13d17ad4cd3414e8acfd648f89873d6Test

المؤلفون: Min Choon Tan, Yong Hao Yeo, Qi Xuan Ang, Bryan E‐Xin Tan, Pattara Rattanawong, Jian Liang Tan, Justin Z. Lee

المصدر: Journal of Arrhythmia, Vol 39, Iss 4, Pp 672-675 (2023)

مصطلحات موضوعية: catheter ablation, in‐hospital outcomes, obesity, procedural complications, ventricular tachycardia, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Abstract Background Evidence on the impact of obesity on catheter ablation for ventricular tachycardia (VT) is scarce. Method and Results We queried the Nationwide Readmissions Database to determine the hospital outcomes and procedural complications of VT ablation among the obese and nonobese populations. Obesity was associated with a more prolonged length of stay (p

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1880-4276Test; https://doaj.org/toc/1883-2148Test

الوصول الحر: https://doaj.org/article/fab1351af8aa44df938a0a868ae2879fTest

المؤلفون: Nicoletta Miano, Giorgia Todaro, Maurizio Di Marco, Sabrina Scilletta, Giosiana Bosco, Francesco Di Giacomo Barbagallo, Roberto Scicali, Salvatore Piro, Francesco Purrello, Antonino Di Pino

المصدر: Nutrients, Vol 16, Iss 12, p 1925 (2024)

مصطلحات موضوعية: malnutrition, hepatic steatosis, CONUT score, in-hospital outcomes, internal medicine, Nutrition. Foods and food supply, TX341-641

الوصف: Fatty liver disease has been identified as a marker of malnutrition in different clinical settings. Recently, the COntrolling NUTritional status score (CONUT score) emerged as a promising tool for malnutrition assessment. Our aim was to evaluate short-term outcomes among patients with malnutrition-related liver steatosis in an Internal Medicine department. Furthermore, we evaluated the association of the CONUT score with malnutrition-related liver steatosis. Data from 247 patients hospitalized in an Internal Medicine department were retrospectively collected. The study population was stratified into three groups based on hepatic radiodensity assessed with computed tomography: mild steatosis (≥56.1 HU), moderate steatosis (between 49.7 and 56 HU), and severe steatosis (≤49.6 HU). We then calculated the CONUT score. Severe steatosis patients had higher in-hospital mortality (18.2 vs. 15.5%) and longer in-hospital stays compared with the mild steatosis group (length of in-hospital stay longer than 12 days: 45% vs. 40%). Logistic regression analysis showed that severe steatosis was not significantly associated with in-hospital all-cause death, while a high CONUT score was an independent risk factor for sepsis. We found an independent relationship between malnutrition-associated liver steatosis and the CONUT score. These results identified the CONUT score as a tool for nutritional assessment of hospitalized patients.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2072-6643/16/12/1925Test; https://doaj.org/toc/2072-6643Test

الوصول الحر: https://doaj.org/article/f2ae91469300420f9711c9ac2b4c1793Test

المؤلفون: Rosa J. Thuemmler, Tiberiu A. Pana, Ben Carter, Ribeya Mahmood, Joao H. Bettencourt-Silva, Anthony K. Metcalf, Mamas A. Mamas, John F. Potter, Phyo K. Myint

المصدر: Nutrients, Vol 16, Iss 10, p 1486 (2024)

مصطلحات موضوعية: ischaemic stroke, albumin, long-term mortality, in-hospital outcomes, nutritional, Nutrition. Foods and food supply, TX341-641

الوصف: Hypoalbuminemia associates with poor acute ischemic stroke (AIS) outcomes. We hypothesised a non-linear relationship and aimed to systematically assess this association using prospective stroke data from the Norfolk and Norwich Stroke and TIA Register. Consecutive AIS patients aged ≥40 years admitted December 2003–December 2016 were included. Outcomes: In-hospital mortality, poor discharge, functional outcome (modified Rankin score 3–6), prolonged length of stay (PLoS) > 4 days, and long-term mortality. Restricted cubic spline regressions investigated the albumin–outcome relationship. We updated a systematic review (PubMed, Scopus, and Embase databases, January 2020–June 2023) and undertook a meta-analysis. A total of 9979 patients were included; mean age (standard deviation) = 78.3 (11.2) years; mean serum albumin 36.69 g/L (5.38). Compared to the cohort median, albumin < 37 g/L associated with up to two-fold higher long-term mortality (HRmax; 95% CI = 2.01; 1.61–2.49) and in-hospital mortality (RRmax; 95% CI = 1.48; 1.21–1.80). Albumin > 44 g/L associated with up to 12% higher long-term mortality (HRmax1.12; 1.06–1.19). Nine studies met our inclusion criteria totalling 23,597 patients. Low albumin associated with increased risk of long-term mortality (two studies; relative risk 1.57 (95% CI 1.11–2.22; I2 = 81.28)), as did low-normal albumin (RR 1.10 (95% CI 1.01–1.20; I2 = 0.00)). Strong evidence indicates increased long-term mortality in AIS patients with low or low-normal albumin on admission.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2072-6643/16/10/1486Test; https://doaj.org/toc/2072-6643Test

الوصول الحر: https://doaj.org/article/3df126a53935446eb7aad00b8866d878Test

المؤلفون: Lujing Jiang, JunGuo Jin, Xuyu He, Xiangming Hu, Lan Guo, Guo Chen, Yingling Zhou

مصطلحات موضوعية: Medicine, Molecular Biology, Biotechnology, Immunology, Science Policy, Hematology, Computational Biology, Space Science, Biological Sciences not elsewhere classified, Mathematical Sciences not elsewhere classified, Chemical Sciences not elsewhere classified, Uric acid, SUA/Scr, Elderly patients, Acute myocardial infarction, In-hospital outcomes

الوصف: Supplementary Material 1

العلاقة: https://figshare.com/articles/journal_contribution/Additional_file_1_of_The_association_between_serum_uric_acid_serum_creatinine_ratio_and_in-hospital_outcomes_in_elderly_patients_with_acute_myocardial_infarction/25010339Test

الإتاحة: https://doi.org/10.6084/m9.figshare.25010339.v1Test
https://figshare.com/articles/journal_contribution/Additional_file_1_of_The_association_between_serum_uric_acid_serum_creatinine_ratio_and_in-hospital_outcomes_in_elderly_patients_with_acute_myocardial_infarction/25010339Test

المؤلفون: Wang, Miao, Liu, Jing, Liu, Jun, Hao, Yongchen, Yang, Na, Liu, Tong, Smith, Sidney C, Huo, Yong, Fonarow, Gregg C, Ge, Junbo, Morgan, Louise, Ma, Changsheng, Han, Yaling, Zhao, Dong, Zhan, Siyan

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Heart Disease - Coronary Heart Disease, Clinical Research, Heart Disease, Cardiovascular, Prevention, early treatment, heart failure, in-hospital outcomes, myocardial infarction, β-blocker, Cardiovascular medicine and haematology

الوصف: BackgroundThere are limited data available on the impact of early (within 24 h of admission) β-blocker therapy on in-hospital outcomes of patients with ST-elevation myocardial infarction (STEMI) and mild-moderate acute heart failure. This study aimed to explore the association between early oral β-blocker therapy and in-hospital outcomes.MethodsInpatients with STEMI and Killip class II or III heart failure from the Improving Care for Cardiovascular Disease in China project (n = 10,239) were enrolled. The primary outcome was a combined endpoint composed of in-hospital all-cause mortality, successful cardiopulmonary resuscitation after cardiac arrest, and cardiogenic shock. Inverse-probability-of-treatment weighting, multivariate Cox regression, and propensity score matching were performed.ResultsEarly oral β-blocker therapy was administered to 56.5% of patients. The incidence of the combined endpoint events was significantly lower in patients with early therapy than in those without (2.7 vs. 5.1%, P < 0.001). Inverse-probability-of-treatment weighting analysis demonstrated that early β-blocker therapy was associated with a low risk of combined endpoint events (HR = 0.641, 95% CI: 0.486-0.844, P = 0.002). Similar results were shown in multivariate Cox regression (HR = 0.665, 95% CI: 0.496-0.894, P = 0.007) and propensity score matching (HR = 0.633, 95% CI: 0.453-0.884, P = 0.007) analyses. A dose-response trend between the first-day β-blocker dosages and adverse outcomes was observed in a subset of participants with available data. No factor could modify the association of early treatment and the primary outcomes among the subgroups analyses.ConclusionBased on nationwide Chinese data, early oral β-blocker therapy is independently associated with a lower risk of poor in-hospital outcome in patients with STEMI and Killip class II or III heart failure.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3s23p5b9Test