Circulation. Heart failure
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Comparative Study
Extracorporeal Membrane Oxygenation as a Bridge to Durable Mechanical Circulatory Support: An Analysis of the STS-INTERMACS Database.
Limited data are available regarding the outcomes of patients supported by extracorporeal membrane oxygenation (ECMO) who undergo durable mechanical circulatory support implantation (dMCS). We analyzed the clinical characteristics, outcomes, and risk factors for mortality in patients who were bridged with ECMO to dMCS. ⋯ ECMO-supported patients before dMCS have lower survival compared with other IP-1 patients. A multivariable analysis showed that ECMO is an independent risk factor of poor outcome after dMCS. However, a propensity matched analysis suggested that when important clinical variables are controlled the outcome of both groups is similar. These data support the implantation of dMCS in carefully selected ECMO patients.
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Comparative Study
Comparison of BNP and NT-proBNP in Patients With Heart Failure and Reduced Ejection Fraction.
Both BNP (B-type natriuretic peptide) and NT-proBNP (N-terminal pro B-type natriuretic peptide) are widely used to aid diagnosis, assess the effect of therapy, and predict outcomes in heart failure and reduced ejection fraction. However, little is known about how these 2 peptides compare in heart failure and reduced ejection fraction, especially with contemporary assays. Both peptides were measured at screening in the PARADIGM-HF trial (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure). ⋯ The ratio of NT-proBNP to BNP in heart failure and reduced ejection fraction appears to be greater than generally appreciated, differs between patients with and without atrial fibrillation, and increases substantially with increasing age and decreasing renal function. These findings are important for comparison of natriuretic peptide concentrations in heart failure and reduced ejection fraction.
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Comparative Study
Regional Variation in the Management and Outcomes of Acute Myocardial Infarction With Cardiogenic Shock in the United States.
There are few studies evaluating regional disparities in the care of acute myocardial infarction-cardiogenic shock (AMI-CS). ⋯ There remain significant regional disparities in the management and outcomes of AMI-CS.
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Extracorporeal membrane oxygenation (ECMO) is increasingly used in acute myocardial infarction (AMI); however, there are limited large-scale national data. ⋯ In AMI admissions, a steady increase was noted in the utilization of ECMO alone and with concomitant procedures (percutaneous coronary intervention, intra-aortic balloon pump, and percutaneous LVAD). In-hospital mortality remained high in AMI admissions treated with ECMO.
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To describe characteristics and outcomes in women and men with heart failure with preserved ejection fraction. ⋯ URL: https://www.clinicaltrials.gov. Unique identifier: NCT00853658, NCT01035255.