Pub Date : 2023-10-01DOI: 10.1016/j.rccl.2023.06.001
Chad M. House , Huong Dang , Katie A. Moriarty , William B. Nelson
Introduction and objectives
Evaluate patients referred for cardiac rehabilitation to determine the prevalence of cognitive impairment (CI) and compare readmission rates and mortality for those with and without CI.
Methods
Patients were retrospectively divided into cohort A (Mini-Cog completed) and cohort B (Mini-Cog not completed). Cohort A was then divided into A1 (Mini-Cog positive for CI) and A2 (Mini-Cog negative for CI).
Results
Of 1440 patients, 986 (68%) completed the Mini-Cog (cohort A) and 454 (32%) patients did not (cohort B). Within cohort A, 46 (4.7%) had a positive Mini-Cog (cohort A1) and 940 (95.3%) had a negative Mini-Cog (cohort A2). Cohort A1 had significantly higher rates of all-cause readmission compared with cohorts A2 and B (63% vs 44% and 47%; P = .02), and significantly higher mortality (28% vs 9% vs 15%; P < .001), but was also significantly older, with more co-morbidities. After accounting for demographic and co-morbidity differences between cohorts A1 and A2 using propensity score matching and Cox proportional hazards model, cohort A1 had significantly increased rates of the composite outcome of readmission and/or death at 3-months (P = .002).
Conclusions
Poor performance on the Mini-Cog identified an older group of phase I cardiac rehabilitation patients that had significantly increased rates of the combined end-point of readmission plus death.
{"title":"Prevalence and impact of cognitive impairment assessed by Mini-Cog in hospitalized cardiac rehabilitation referrals","authors":"Chad M. House , Huong Dang , Katie A. Moriarty , William B. Nelson","doi":"10.1016/j.rccl.2023.06.001","DOIUrl":"10.1016/j.rccl.2023.06.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Evaluate patients referred for cardiac rehabilitation to determine the prevalence of cognitive impairment (CI) and compare readmission rates and mortality for those with and without CI.</p></div><div><h3>Methods</h3><p>Patients were retrospectively divided into cohort A (Mini-Cog completed) and cohort B (Mini-Cog not completed). Cohort A was then divided into A<sub>1</sub> (Mini-Cog positive for CI) and A<sub>2</sub> (Mini-Cog negative for CI).</p></div><div><h3>Results</h3><p>Of 1440 patients, 986 (68%) completed the Mini-Cog (cohort A) and 454 (32%) patients did not (cohort B). Within cohort A, 46 (4.7%) had a positive Mini-Cog (cohort A<sub>1</sub>) and 940 (95.3%) had a negative Mini-Cog (cohort A<sub>2</sub>). Cohort A<sub>1</sub> had significantly higher rates of all-cause readmission compared with cohorts A<sub>2</sub> and B (63% vs 44% and 47%; <em>P</em> <!-->=<!--> <em>.02</em>), and significantly higher mortality (28% vs 9% vs 15%; <em>P</em> <!--><<!--> <em>.001</em>), but was also significantly older, with more co-morbidities. After accounting for demographic and co-morbidity differences between cohorts A<sub>1</sub> and A<sub>2</sub><span><span> using propensity score matching and Cox </span>proportional hazards model, cohort A</span><sub>1</sub> had significantly increased rates of the composite outcome of readmission and/or death at 3-months (<em>P</em> <!-->=<!--> <em>.002</em>).</p></div><div><h3>Conclusions</h3><p>Poor performance on the Mini-Cog identified an older group of phase I cardiac rehabilitation patients that had significantly increased rates of the combined end-point of readmission plus death.</p></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"58 4","pages":"Pages 272-280"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45486669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1016/j.rccl.2023.07.006
Eduardo Arana-Rueda, Manuel Frutos-López, Alonso Pedrote
{"title":"Utilidad de los fármacos antiarrítmicos tras la ablación de la fibrilación auricular","authors":"Eduardo Arana-Rueda, Manuel Frutos-López, Alonso Pedrote","doi":"10.1016/j.rccl.2023.07.006","DOIUrl":"10.1016/j.rccl.2023.07.006","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"58 4","pages":"Pages 257-259"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46717060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1016/j.rccl.2023.06.002
Alberto Esteban-Fernández , Manuel Méndez-Bailón , Mónica Pérez-Serrano , Teresa Morales Martínez , Julia Gómez Diego , Ángel Nieto , María Molina , Julián Pérez Villacastín , Inmaculada Fernández Rozas , Ramón Bover
Introduction and objectives
Iron deficiency (ID) is common in heart failure (HF) patients and is linked to exercise impairment, worse quality of life, and HF hospitalisation. Clinical practice guidelines recommend checking and correcting ID with ferric carboxymaltose (FCM). However, there is a lack of evidence in patients with left ventricular ejection fraction (LVEF) >40%.
Methods
We included all HF outpatients treated with FCM after ID diagnosis (ferritin <100 ng/mL or ferritin 100–299ng/mL and transferrin saturation <20%). We analysed clinical and analytical parameters before FCM administration and at 3 months according to LVEF: preserved (>50%), mildly reduced (41–49%), and reduced (<40%).
Results
We included 235 patients (51.5% female) aged 73.5 ± 10.7 years. Ninety-six patients have reduced LVEF (40.8%), 41 mildly reduced (17.4%), and 98 preserved (41.7%). Patients with preserved LVEF have more anaemia (42.6% vs 26.8% vs 52.6%; P = .02). Less than 50% of patients received the correct dose of FCM, especially patients with preserved LVEF (P = .004). One patient (0.4%) presented a local exanthema with no other adverse effects. At 3 months, all analytical parameters significantly improved, except haemoglobin (12.9 vs 13.0 mg/dL; P = .95) and natriuretic peptides (3261 vs 3471 pg/mL; P = .56) in mildly reduced LVEF patients. The functional class did not improve in preserved LVEF patients, but it did in the rest.
Conclusions
FCM is safe and effective in correcting ID in HF patients regardless of LVEF. Natriuretic peptides are reduced in all patients except those with mildly reduced LVEF. Functional class improvement is less likely in patients with preserved LVEF.
引言和目的心力衰竭（HF）患者中常见的是缺铁（ID），它与运动障碍、生活质量下降和HF住院有关。临床实践指南建议用羧麦芽糖铁（FCM）检查和纠正ID。然而，在左心室射血分数（LVEF）>；方法我们纳入了所有在ID诊断后接受FCM治疗的HF门诊患者（铁蛋白＜100 ng/mL或铁蛋白100–299 ng/mL，转铁蛋白饱和度＜20%）。我们分析了FCM给药前和3个月时根据LVEF的临床和分析参数：保留（>；50%）、轻度降低（41-49%）和降低（<；40%）。结果我们包括235名患者（51.5%女性），年龄73.5±10.7岁。96名患者LVEF降低（40.8%），41名轻度降低（17.4%），98名患者（41.7%）。LVEF保持的患者贫血程度更高（42.6%对26.8%对52.6%；P=0.02）。只有不到50%的患者接受了正确剂量的FCM治疗，尤其是LVEF保存的患者（P=0.004）。一名患者（0.4%）出现局部皮疹，没有其他不良反应。在3个月时，除轻度LVEF降低患者的血红蛋白（12.9 vs 13.0 mg/dL；P=.95）和利钠肽（3261 vs 3471 pg/mL；P=.56）外，所有分析参数均显著改善。LVEF患者的功能分类没有改善，但在其他患者中有改善。结论FCM在纠正HF患者的ID方面是安全有效的，无论LVEF如何。除LVEF轻度降低的患者外，所有患者的利钠肽均降低。左心室射血分数保留的患者的功能类别改善的可能性较小。
{"title":"Ferric carboxymaltose for patients with heart failure in all-range ejection fraction","authors":"Alberto Esteban-Fernández , Manuel Méndez-Bailón , Mónica Pérez-Serrano , Teresa Morales Martínez , Julia Gómez Diego , Ángel Nieto , María Molina , Julián Pérez Villacastín , Inmaculada Fernández Rozas , Ramón Bover","doi":"10.1016/j.rccl.2023.06.002","DOIUrl":"10.1016/j.rccl.2023.06.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Iron deficiency (ID) is common in heart failure (HF) patients and is linked to exercise impairment, worse quality of life<span>, and HF hospitalisation. Clinical practice guidelines recommend checking and correcting ID with ferric carboxymaltose<span> (FCM). However, there is a lack of evidence in patients<span> with left ventricular ejection fraction (LVEF) >40%.</span></span></span></p></div><div><h3>Methods</h3><p>We included all HF outpatients treated with FCM after ID diagnosis (ferritin <100<!--> <span>ng/mL or ferritin 100–299</span> <span>ng/mL and transferrin saturation <20%). We analysed clinical and analytical parameters before FCM administration and at 3 months according to LVEF: preserved (>50%), mildly reduced (41–49%), and reduced (<40%).</span></p></div><div><h3>Results</h3><p>We included 235 patients (51.5% female) aged 73.5<!--> <!-->±<!--> <!-->10.7 years. Ninety-six patients have reduced LVEF (40.8%), 41 mildly reduced (17.4%), and 98 preserved (41.7%). Patients with preserved LVEF have more anaemia (42.6% vs 26.8% vs 52.6%; <em>P</em> <!-->=<!--> <!-->.02). Less than 50% of patients received the correct dose of FCM, especially patients with preserved LVEF (<em>P</em> <!-->=<!--> <!-->.004). One patient (0.4%) presented a local exanthema with no other adverse effects. At 3 months, all analytical parameters significantly improved, except haemoglobin (12.9 vs 13.0<!--> <!-->mg/dL; <em>P</em> <!-->=<!--> <span>.95) and natriuretic peptides (3261 vs 3471</span> <!-->pg/mL; <em>P</em> <!-->=<!--> <!-->.56) in mildly reduced LVEF patients. The functional class did not improve in preserved LVEF patients, but it did in the rest.</p></div><div><h3>Conclusions</h3><p>FCM is safe and effective in correcting ID in HF patients regardless of LVEF. Natriuretic peptides are reduced in all patients except those with mildly reduced LVEF. Functional class improvement is less likely in patients with preserved LVEF.</p></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"58 4","pages":"Pages 281-288"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46466532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1016/j.rccl.2023.05.005
Pablo Martín-Marín, Antonio Delgado-Ariza, Alba Abril Molina, Jaime Nevado-Portero
{"title":"Serie de casos: síndrome de Kounis, una entidad infradiagnosticada","authors":"Pablo Martín-Marín, Antonio Delgado-Ariza, Alba Abril Molina, Jaime Nevado-Portero","doi":"10.1016/j.rccl.2023.05.005","DOIUrl":"10.1016/j.rccl.2023.05.005","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"58 4","pages":"Pages 329-331"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44309947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1016/j.rccl.2023.07.008
Manuel Gómez Bueno , Javier Segovia Cubero
{"title":"Abordaje de la hipertensión pulmonar en España. ¿Cuál es nuestra guía?","authors":"Manuel Gómez Bueno , Javier Segovia Cubero","doi":"10.1016/j.rccl.2023.07.008","DOIUrl":"10.1016/j.rccl.2023.07.008","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"58 4","pages":"Pages 253-256"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42332699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1016/j.rccl.2023.03.008
Javier Torres Llergo, Miguel Puentes Chiachío, José María Segura Aumente, Juan Carlos Fernández Guerrero, María Rosa Fernández Olmo
{"title":"Experiencia clínica y seguridad de la terapia fundacional en el paciente hospitalizado por insuficiencia cardiaca","authors":"Javier Torres Llergo, Miguel Puentes Chiachío, José María Segura Aumente, Juan Carlos Fernández Guerrero, María Rosa Fernández Olmo","doi":"10.1016/j.rccl.2023.03.008","DOIUrl":"10.1016/j.rccl.2023.03.008","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"58 4","pages":"Pages 324-327"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42435428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号