International journal of cardiology
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Multicenter Study Comparative Study
Prognostic impact of in-hospital hyperglycemia in hospitalized patients with acute heart failure: Results of the IN-HF (Italian Network on Heart Failure) Outcome registry.
Although diabetes mellitus is frequently associated with heart failure (HF), the association between elevated admission glucose levels and adverse outcomes has not been well established in hospitalized patients with acute HF. ⋯ Elevated admission blood glucose levels are associated with poorer in-hospital survival outcomes in patients with acute HF, especially in those with previously known diabetes. This finding further highlights the importance of tight glycemic control during hospital stay and address the need of dedicated intervention studies to identify customized clinical protocols to improve in-hospital survival of these high-risk patients.
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Recent studies have indicated that it may be safe to discharge chest pain patients with an initial high-sensitivity cardiac troponin T (hs-cTnT) level of <5 ng/L from the emergency department (ED) without further evaluation. We sought to assess the effects of discharge from the ED versus admission to hospital on downstream resource utilisation in low-risk chest pain patients. ⋯ Increased risks of revisit to the ED, hospitalisation, coronary angiography, and revascularisation were observed when patients with chest pain and hs-cTnT levels of <5 ng/L were admitted instead of discharged home.
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Contemporary data on trends of acute myocardial infarction (AMI), particularly outcomes of hospital survivors by AMI type is sparse. ⋯ Throughout 2002-2012 significant decline in the incidence and of in-hospital mortality of STEMI were found. However, adjusted post-discharge mortality rates increased significantly with time. Measures for improving incidence and outcomes of AMI patients focusing on NSTEMI and hospital-survivors are warranted.
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Peripheral arterial disease (PAD) and atrial fibrillation (AF) share several comorbidities and contribute to similar cardiovascular (CV) outcomes. Only few studies have evaluated the correlation between PAD, AF, and their interaction effects on CV outcomes. ⋯ PAD is an independent risk factor of incident AF but not vice versa. Both PAD and AF are independent risk factors for stroke, heart failure hospitalization, and CV death.