Clinical cardiology
-
Clinical cardiology · Oct 2020
Multicenter Study Comparative StudyBioprosthetic vs mechanical mitral valve replacement for infective endocarditis in patients aged 50 to 69 years.
The optimal choice of the valve prosthesis in mitral valve replacement (MVR) for infective endocarditis (IE) is controversial and challenging, particularly for younger patients. ⋯ Mechanical valve prostheses were associated with better survival, lower rates of reoperation compared with bioprostheses within 15 years after MVR in IE patients aged 50 to 69. These findings suggest mechanical valve prostheses may be a more reasonable alternative to bioprostheses in this patient group.
-
Clinical cardiology · Oct 2020
Multicenter Study Observational Study"Missing" acute coronary syndrome hospitalizations during the COVID-19 era in Greece: Medical care avoidance combined with a true reduction in incidence?
Reports from countries severely hit by the COVID-19 pandemic suggest a decline in acute coronary syndrome (ACS)-related hospitalizations. The generalizability of this observation on ACS admissions and possible related causes in countries with low COVID-19 incidence are not known. ⋯ We observed a reduction in ACS hospitalizations during the COVID-19 outbreak in a country with strict social measures, low community transmission, and no excess in mortality. Medical care avoidance behavior is an important factor for these observations, while a true reduction of the ACS incidence due to self-isolation/quarantining may have also played a role.
-
Clinical cardiology · Nov 2019
Multicenter StudyDecision tree model for predicting in-hospital cardiac arrest among patients admitted with acute coronary syndrome.
In-hospital cardiac arrest (IHCA) may be preventable, with patients often showing signs of physiological deterioration before an event. Our objective was to develop and validate a simple clinical prediction model to identify the IHCA risk among cardiac arrest (CA) patients hospitalized with acute coronary syndrome (ACS). ⋯ We have developed and internally validated a good discrimination decision tree model to predict the risk of IHCA. This simple prediction model may provide healthcare workers with a practical bedside tool and could positively impact decision-making with regard to deteriorating patients with ACS.
-
Clinical cardiology · Mar 2019
Multicenter StudyAnticoagulation in patients with atrial fibrillation and heart failure: Insights from the NCDR PINNACLE-AF registry.
In non-valvular atrial fibrillation (NVAF) patients, congestive heart failure (CHF) confers an increased risk of stroke or systemic thromboembolism. This risk is present in both heart failure (HF) with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). It is unclear if clinicians account for both types of CHF in their NVAF anticoagulation practices. Accordingly, we characterized current outpatient anticoagulation trends in NVAF patients with HFpEF compared to patients with HFrEF. ⋯ Patients with NVAF and HFpEF have significantly lower anticoagulation rates when compared to their HFrEF counterparts. These findings suggest a potential underappreciation of HFpEF as a risk factor in patients with NVAF.
-
Clinical cardiology · Jan 2019
Multicenter StudyImpact of atrial fibrillation on patients hospitalized for acute myocarditis: Insights from a nationally-representative United States cohort.
Atrial fibrillation (AF) is associated with increased all-cause mortality in the general population. However, the impact of AF on the in-hospital outcomes of acute myocarditis (AM) patients is not well characterized. ⋯ AF was associated with increased risk of in-hospital mortality and complications in patients admitted to the hospital with acute myocarditis.