Readmission-free period and in-hospital mortality at the time of first readmission in acute heart failure patients —NRD-based analysis of 40,000 heart failure readmissions

AbstractThe 30-day readmission rates, predictors, and outcomes for acute heart failure (AHF) patients are well published, but data beyond 30  days and the association between readmission-free period (RFP) and in-hospital readmission-related mortality remain unknown. We queried the National Readmission Database to analyze comparative outcomes of AHF. Patients were divided into three groups based on their RFP: group 1 (1–30 days), grou p 2 (31–90 days), and group 3 (91–275 days). AHF cases and clinical variables were identified using ICD-9 codes. The primary outcome was in-hospital mortality at the time of readmission. A total of 39,237 unplanned readmissions occurred within 275 days; 15,181 within group 1, 11,925 within gr oup 2, and 12,131 within group 3. In-hospital mortality in groups 1, 2, and 3 were 7.4%, 5.1%, and 4.1% (p 
Source: Heart Failure Reviews - Category: Cardiology Source Type: research

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ConclusionsAcute qRBBB myocardial infarction is a sinister form of acute coronary syndrome which entails high in-hospital mortality and morbidity, necessitating early recognition and prompt institution of reperfusion therapy. Extreme deviation of QRS axis to the right [180-269 degrees] is a significant electrocardiographic predictor of in-hospital mortality.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Cardiogenic shock (CS) is the most serious complication of acute myocardial infarction (AMI). The practice of early revascularization by percutaneous coronary intervention, and advances in pharmacotherapy have reduced the rate of complications of CS. However, when CS is combined with AMI, mortality from AMI is still high, and many clinicians are wondering how to treat CS with AMI. In recent years, mechanical circulatory support (MCS) devices have improved the clinical outcome in AMI patients with CS. For best outcome, treatment of AMI with CS should always consider treatments that improve the prognosis of the patients.
Source: Heart Failure Clinics - Category: Cardiology Authors: Source Type: research
Purpose of review Cardiogenic shock remains a complex clinical syndrome with high morbidity and mortality. The purpose of this article is to review important landmark trials as well as the relevant recent literature for percutaneous mechanical circulatory support following acute myocardial infarction. Recent findings The sole use of intraaortic balloon pumps for cardiogenic shock following acute myocardial infarction continues to be questioned with downgrading of its recommendation in recent years, there however may remain a role in patients with mechanical complications of their myocardial infarction. The combined us...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: HEART FAILURE: Edited by Haissam Haddad Source Type: research
Cardiology MCQ – Classic cardiogenic shock – Answer My Cardiology MCQ books on Amazon “Classic” cardiogenic shock having hypotension with features of hypoperfusion, needing inotropes and mechanical circulatory support comes under Stage — of the 2019 SCAI (Society for Cardiovascular Angiography and Intervention) classification: Correct answer: 3. Stage C The Society for Cardiovascular Angiography and Intervention (SCAI) has classified cardiogenic shock into stages from A through E. Stage A: “At risk” for cardiogenic shock – large myocardial infarction or heart failure, but no...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
The Society for Cardiovascular Angiography and Intervention (SCAI) has classified cardiogenic shock into stages from A through E. This was developed by a multidisciplinary team from cardiology (interventional, advanced heart failure and noninvasive), emergency medicine, critical care and cardiac nursing. Stage A: “At risk” for cardiogenic shock – large myocardial infarction or heart failure, but not yet in shock, with normal mentation and systolic blood pressure of 100 mm Hg or more. Stage B: “Beginning” shock – hypotension or tachycardia without features of hypoperfusion (normal mentation). Systolic BP
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Source Type: blogs
Background Diabetes mellitus predicts poorer outcomes in patients with acute coronary syndrome (ACS), but the magnitude of this association in patients at older ages remains controversial. Methods Data were extracted from the Codi Infart database. All consecutive patients with diagnosis of ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) between 2010 and 2015 were included. We assessed the impact of diabetes mellitus on 30-day and one-year mortality in patients aged less than and at least 75 years. Results A total of 12 792 cases were registered, of whom...
Source: Coronary Artery Disease - Category: Cardiology Tags: Myocardial Infarction/Cardiogenic Shock Source Type: research
ConclusionsSpontaneous reperfusion prior to pPCI in STEMI was associated with a lower risk of adverse clinical events. These exploratory data from a targeted discovery proteomics platform identifies novel proteins across diverse, yet complementary, pathobiological axes that show promise in providing mechanistic insights into spontaneous reperfusion in STEMI.Condensed abstractSpontaneous reperfusion has been established with improved STEMI outcomes, yet its pathobiology is unclear and appears to involve diverse physiological processes. Using a 91-biomarker high-throughput proteomics platform, we studied 683 STEMI patients i...
Source: American Heart Journal - Category: Cardiology Source Type: research
Authors: Chen J, He Y, Hao Y, Yu X, Zhang G, Zhu J, Yao Y Abstract Cardiogenic shock is the most severe form of acute heart failure. The aim of the current study was to investigate correlations between diagnostic parameters and the estimated ejection fraction in patients with cardiogenic shock. A total of 2,445 patients with acute myocardial infarction were subjected to coronary angiograms and standard 2D transthoracic echocardiography. Information for culprit vessel(s) and mitral regurgitation were collected. The Spearman's correlation test was used to assess the correlation between diagnostic parameters and estim...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
AbstractAimsThe aim of this study was to determine the incidence, predictors, and short ‐term and long‐term outcomes associated with in‐hospital sustained ventricular tachycardia (VT) and ventricular fibrillation (VF) collectively termed ventricular arrhythmia (VA) in the heart failure (HF) patients.Methods and resultsThe HEart function Assessment Registry Trial in Saudi Arabia (HEARTS registry) is a prospective national registry of patients with chronic HF from18 tertiary care hospitals across Saudi Arabia. Diagnosis of HF was in accordance with American Heart Association/European Society of Cardiology definition cr...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
Publication date: Available online 9 November 2019Source: Canadian Journal of CardiologyAuthor(s): Daniel H. KimAbstractCardiogenic Shock (CS) accounts for 15% of all Cardiac Intensive Care Unit admissions, with Acute Myocardial Infarction Cardiogenic Shock (AMICS) accounting for 30% of these. In contrast to other areas in cardiac care where survival has continued to improve over the last two decades, CS still carries a mortality of around 40%. Temporary Mechanical Circulatory Support (tMCS) therapies have shown inconsistent results in improving outcomes in CS, with the overall evidence not supporting its use, at least not...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
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