0000000000198989
AUTHOR
Rocío Robles
Limitations of Clinical History for Evaluation of Patients With Acute Chest Pain, Non-Diagnostic Electrocardiogram, and Normal Troponin
Decision making and risk stratification for patients with acute chest pain, nondiagnostic electrocardiogram results, and normal troponin levels are challenging. The aim of this study was to optimize the clinical history for the evaluation of these patients. A total of 1,011 patients presenting to an emergency department were included. The following data were collected: clinical presentation (pain characteristics and number of pain episodes), coronary risk factors, previous ischemic heart disease, and extracardiac vascular disease (peripheral artery disease, stroke, or creatinine >1.4 mg/dl). Two different predictive models were calculated according to the end points: model 1 for 1-year majo…
Implicaciones pronósticas del péptido natriurético cerebral en la insuficiencia cardiaca aguda: mortalidad y reingresos hospitalarios
El valor pronostico del peptido natriuretico cerebral (BNP) tras un episodio de insuficiencia cardiaca aguda (ICA) no ha sido totalmente establecido. El objetivo de este trabajo fue evaluar la relacion entre las concentraciones de BNP y la mortalidad y los reingresos por ICA. Analizamos a 569 pacientes ingresados consecutivamente con el diagnostico de ICA. Se determino el BNP tras la estabilizacion inicial del paciente. La relacion entre el BNP y la mortalidad fue evaluada mediante regresion de Cox y la relacion con el reingreso, mediante regresion con ajuste para episodios competitivos. Durante una mediana de seguimiento de 9 (3-18) meses, se registraron 156 muertes (27,4%) y 140 reingreso…
Hyperuricemia in acute heart failure. More than a simple spectator?
Hyperuricemia is a prevalent condition in chronic heart failure (CHF), describing increased oxidative stress and inflammation. Although there is evidence that serum uric acid (UA) predicts mortality in CHF, its role as a prognostic biomarker in acute heart failure (AHF) has not yet been well assessed. The aim of this study was to determine if UA levels predict all-cause mortality. Additionally, as a secondary endpoint we sought the clinical predictors of UA serum level in this population.We analyzed 560 consecutive patients with AHF admitted in a single university center. UA (mg/dl) was measured during early hospitalization. Patient survival status was followed up after discharge (median fo…
Prognostic implications of arterial blood gases in acute decompensated heart failure
The prognostic value of arterial blood gases (ABG) in patients with acute decompensated heart failure (ADHF) is not well-established. We therefore conducted the present study to determine the relationship between ABG on admission and long-term mortality in patients with ADHF.We studied 588 patients consecutively admitted to our department with ADHF. ABG and classical prognostic variables were determined at patients' arrival to the emergency department. The independent association among the main variables of ABG (pO2, pCO2 and pH) and mortality was assessed with Cox regression analysis.At a median follow-up of 23months, 221 deaths (37.6%) were registered. 308 (52.4%), 54 (9.2%) and 50 (8.5%)…
Carbohydrate antigen 125: an emerging prognostic risk factor in acute heart failure?
To assess whether circulating levels of carbohydrate antigen 125 (CA125) predict subsequent 6-month all-cause mortality in patients after the index hospitalisation for acute heart failure (HF).Prospective cohort study at a single teaching centre in Spain.529 consecutive patients with acute HF admitted in a single university centre were analysed. In addition to the traditional clinical information, CA125 (U/ml) was measured during the early course of hospitalisation. The independent association between baseline CA125 and mortality was assessed with Cox regression analysis. The follow-up was limited to 6 months.349 (66%) patients showed serum levels of CA12535 U/ml (established cut-off point …
Prognostic Value of Brain Natriuretic Peptide in Acute Heart Failure: Mortality and Hospital Readmission
The prognostic value of brain natriuretic peptide (BNP) measurement in patients with acute heart failure is not well understood. The aim of this study was to investigate the relationship between the BNP level and mortality and readmission for acute heart failure. We studied 569 consecutive patients who were admitted with a diagnosis of acute heart failure. The BNP level was measured after the patient became clinically stable. The relationship between the BNP level and mortality was assessed by Cox regression analysis, and the relationship with readmission, by competing risks regression analysis. During a median follow-up period of 9 (range, 3-18) months, 156 deaths (27.4%) and 140 readmissi…