bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-fatal cardiovascular events preceding sudden cardiac death in patients with an acute myocardial infarction complicated by heart failure: insights from the high-risk myocardial infarction database
Authors: Hui Sonya K , Sharma Abhinav , Docherty Kieran , McMurray John J V , Pitt Bertram , Dickstein Kenneth , Pfeffer Marc A , Girerd Nicolas , Rossignol Patrick , Ferreira João Pedro , Zannad Faiez 
Published: January 2021

Abstract

Aims
Among patients with acute myocardial infarction (AMI) complicated by heart failure [HF; clinical HF or left ventricular (LV) systolic dysfunction], we explored the probability of subsequent non-fatal cardiovascular (CV) events and sudden cardiac death (SCD).

Methods and results
The high-risk myocardial infarction (HRMI) database contains 28 771 patients with signs of HF or reduced LV ejection fraction (&lt;40%) after AMI. We evaluated the temporal association between SCD with preceding non-fatal CV event [HF hospitalization, recurrent myocardial infarction (MI), or stroke]. Median follow-up was 1.9 years. Mean age was 65.0 ± 11.5 years and 70% were male. The incidence of CV death was 7.9 per 100 patient-years and for SCD was 3.1 per patient-years (40% of CV deaths). The incidence of SCD preceded by HF hospitalization was greater than SCD without preceding HF hospitalization (P &lt; 0.05). However, overall, SCD was less likely to be preceded by a non-fatal CV event compared to other causes of death: 9.6% of SCD events were preceded by an MI (vs. 46.6% for non-sudden CV death); 17.0% of SCD events were preceded with an HF hospitalization (vs. 25.4% for non-sudden CV death); and 2.7% of SCD events were preceded by stroke (vs.12.9% for non-sudden CV death).

Conclusion
Among patients with AMI complicated by HF, SCD, compared with other causes of death, was less likely to be preceded by a non-fatal CV event. As patients are less likely to have preceding non-fatal CV events to alert the healthcare team of a possible impending SCD event, additional strategies for risk stratification for SCD are needed.
The peak levels of highly sensitive troponin I predicts in-hospital mortality in COVID-19 patients with cardiac injury: a retrospective study
Authors: Wang Yaxin , Shu Huaqing , Liu Hong , Li Xia , Zhou Xing , Zou Xiaojing , Pan Shangwen , Xu Jiqian , Xu Dan , Zhao Xin , Yang Xiaobo , Yu Yuan , Yuan Yin , Qi Hong , Wang Qiongya , Shang You 
Published: January 2021

AbstractAimsTo investigate the association between levels of highly sensitive troponin I (hs-troponin I) and mortality in novel coronavirus disease 2019 (COVID-19) patients with cardiac injury.Methods and resultsWe retrospectively reviewed the medical records of all COVID-19 patients with increased levels of hs-troponin I from two hospitals in Wuhan, China. Demographic information, laboratory test results, cardiac ultrasonographic findings, and electrocardiograms were collected, and their predictive value on in-hospital mortality was explored using multivariable logistic regression. Of 1500 patients screened, 242 COVID-19 patients were enrolled in our study. Their median age was 68 years, and (48.8%) had underlying cardiovascular diseases. One hundred and seventy-six (72.7%) patients died during hospitalization. Multivariable logistic regression showed that C-reactive protein (&gt;75.5 mg/L), D-dimer (&gt;1.5 μg/mL), and acute respiratory distress syndrome were risk factors of mortality, and the peak hs-troponin I levels (&gt;259.4 pg/mL) instead of the hs-troponin I levels at admission was predictor of death. The area under the receiver operating characteristic curve of the peak levels of hs-troponin I for predicting in-hospital mortality was 0.79 (95% confidence interval, 0.73–0.86; sensitivity, 0.80; specificity, 0.72; P &lt; 0.0001).ConclusionOur results demonstrated that the risk of in-hospital death among COVID-19 patients with cardiac injury can be predicted by the peak levels of hs-troponin I during hospitalization and was significantly associated with oxygen supply-demand mismatch, inflammation, and coagulation.
Biomarkers of coagulation and fibrinolysis in acute myocardial infarction: a joint position paper of the Association for Acute CardioVascular Care and the European Society of Cardiology Working Group on Thrombosis
Authors: Krychtiuk Konstantin A , Speidl Walter S , Giannitsis Evangelos , Gigante Bruna , Gorog Diana A , Jaffe Allan S , Mair Johannes , Möckel Martin , Mueller Christian , Storey Robert F , Vilahur Gemma , Wojta Johann , Huber Kurt , Halvorsen Sigrun , Geisler Tobias , Morais Joao , Lindahl Bertil , Thygesen Kristian 
Published: January 2021

Abstract
The formation of a thrombus in an epicardial artery may result in an acute myocardial infarction (AMI). Despite major advances in acute treatment using network approaches to allocate patients to timely reperfusion and optimal antithrombotic treatment, patients remain at high risk for thrombotic complications. Ongoing activation of the coagulation system as well as thrombin-mediated platelet activation may both play a crucial role in this context. Whether measurement of circulating biomarkers of coagulation and fibrinolysis could be useful for risk stratification in secondary prevention is currently not fully understood. In addition, measurement of such biomarkers could be helpful to identify thrombus formation as the leading mechanism for AMI. The introduction of biomarkers of myocardial injury such as high-sensitivity cardiac troponins made rule-out of AMI even more precise. However, elevated markers of myocardial injury cannot provide proof of a type 1 AMI, let alone thrombus formation. The combined measurement of markers of myocardial injury with biomarkers reflecting ongoing thrombus formation might be helpful for the fast and correct diagnosis of an atherothrombotic type 1 AMI. This position paper gives an overview of the current knowledge and possible role of biomarkers of coagulation and fibrinolysis for the diagnosis of AMI, risk stratification, and individualized treatment strategies in patients with AMI.
Right ventricular function and iron deficiency in acute heart failure
Authors: Miñana Gema , Santas Enrique , de la Espriella Rafael , Núñez Eduardo , Lorenzo Miguel , Núñez Gonzalo , Valero Ernesto , Bodí Vicent , Chorro Francisco J , Sanchis Juan , Cohen-Solal Alain , Bayés-Genís Antoni , Núñez Julio 
Published: January 2021

Abstract

Aims
Iron deficiency (ID) is a frequent finding in patients with chronic and acute heart failure (AHF) along the full spectrum of left ventricular ejection fraction (LVEF). Iron deficiency has been related to ventricular systolic dysfunction, but its role in right ventricular function has not been evaluated. We sought to evaluate whether ID identifies patients with greater right ventricular dysfunction in the setting of AHF.

Methods and results
We prospectively included 903 patients admitted with AHF. Right systolic function was evaluated by tricuspid annular plane systolic excursion (TAPSE) and the ratio TAPSE/pulmonary artery systolic pressure (TAPSE/PASP). Iron deficiency was defined, according to European Society of Cardiology criteria, as serum ferritin &lt;100 mg/dL (absolute ID) or ferritin 100–299 mg/dL and transferrin saturation (TSAT) &lt;20% (functional ID). The relationships among the exposures with right ventricular systolic function were evaluated by multivariate linear regression analyses. The mean age of the sample was 74.3 ± 10.6 years, 441 (48.8%) were female, 471 (52.2%) exhibited heart failure with preserved ejection fraction, and 677 (75.0%) showed ID. The mean LVEF, TAPSE, and TAPSE/PASP were 49 ± 15%, 18.6 ± 3.9 mm, and 0.45 ± 0.18, respectively. The median (interquartile range) amino-terminal pro-brain natriuretic peptide was 4015 (1807–8775) pg/mL. In a multivariable setting, lower TSAT and ferritin were independently associated with lower TAPSE (P &lt; 0.05 for both comparisons). Transferrin saturation (P = 0.017), and not ferritin (P = 0.633), was independently associated with TAPSE/PASP.

Conclusion
In AHF, proxies of ID were associated with right ventricular dysfunction. Further studies should confirm these findings and evaluate the pathophysiological facts behind this association.
Spontaneous coronary artery dissection in old patients: clinical features, angiographic findings, management and outcome
Authors: Díez-Villanueva Pablo , García-Guimaraes Marcos , Sanz-Ruiz Ricardo , Roura Gerard , Macaya Fernando , Barahona Alvarado Jean Christophe , Tizón-Marcos Helena , Flores-Ríos Xacobe , Masotti Mónica , Lezcano-Pertejo Cristina , Cortés Carlos , Fuertes-Ferre Georgina , Becerra-Muñoz Víctor Manuel , Lozano Ruiz-Poveda Fernando , Valero Ernesto , Portero-Portaz Juan José , Vera Alberto , Salamanca Jorge , Alfonso Fernando 
Published: January 2021

Abstract

Aims
Spontaneous coronary artery dissection (SCAD) is a relatively rare but well-known cause of acute coronary syndrome. Clinical features, angiographic findings, management and outcomes of SCAD in old patients (&gt;65 years of age) remain unknown.

Methods and results
The Spanish multicentre prospective SCAD registry (NCT03607981), included 318 consecutive patients with SCAD. Data were collected between June 2015 and April 2019. All angiograms were analysed in a centralized corelab. For the purposes of this study, patients were classified according to age in two groups &lt;65 and ≥65 years old and in-hospital outcomes were analysed. Fifty-five patients (17%) were ≥65 years old (95% women). Older patients had more often hypertension (76% vs. 29%, P &lt; 0.01) and dyslipidaemia (56% vs. 30%, P &lt; 0.01), and less previous (4% vs. 18%, P &lt; 0.001) or current smoking habit (4% vs. 33%, P &lt; 0.001). An identifiable trigger was less often present in old patients (27% vs. 43%, P = 0.028). They also had more often severe coronary tortuosity (36% vs. 11%, P = 0.036) and showed more frequently coronary ectasia (24% vs. 9%, P &lt; 0.01). Older patients were more often managed conservatively (89% vs. 75%, P = 0.025), with no significant differences in major adverse cardiac events during index admission (7% vs. 8%, P = 0.858). There were no differences between groups in terms of in-hospital stay, new acute myocardial infarction, unplanned coronary angiography or heart failure.

Conclusion
Older patients with SCAD show different clinical and angiographic characteristics compared with younger patients. Initial treatment strategy was different between groups, though in-hospital outcomes do not significantly differ (NCT03607981).
Partners’ Relative Income and the Risk of Union Dissolution in Two Institutional Contexts
Authors: Hamplová Dana , Le Bourdais Céline , Legendre Blandine 
Published: January 2021

AbstractThis article investigates the link between union stability and women’s contribution to the family income in married and cohabiting couples. Using a data set linking survey data to information from respondents’ annual tax records over a period of nearly 30 years, the study explores the changes over time and the role of institutional context by comparing Quebec and Anglophone Canada. The analysis showed that the risk of dissolution was lowest when men’s and women’s incomes were similar. The U-shaped pattern held for marriage and cohabitation, and for both regions. If the couple deviated from the equality pattern, women’s greater income constituted a more destabilizing factor than men’s greater income. Overall, the observed U-shaped link between relative income and union instability did not change over the study period of 30 years.
Drug non-adherence in hypertensive patients in Morocco, and its associated risk factors
Authors: Essayagh Touria , Essayagh Meriem , Essayagh Sanah 
Published: January 2021

Abstract

Aims
Hypertension is a widespread public health problem; unfortunately, non-adherence to the treatment hinders the control of high blood pressure. Drug non-adherence is the degree to which a patient does not follow the prescription. We aimed to assess the extent of drug non-adherence among hypertensive patients treated in Meknes and identify risk factors associated with inobservance.

Methods and results
Between November and December 2017, we conducted a cross-sectional study enrolling 922 hypertensive patients managed at Meknes’s primary healthcare facilities (PHCF) using the multistage sampling method. We interviewed patients face to face to collect their socio-demographic characteristics, lifestyle behaviours, clinical parameters, and the relationship between the care system, the patient, and the physician. A multivariate logistic regression analysis highlighted the risk factors associated with drug non-adherence. The prevalence of drug non-adherence was 91% with a mean age of 61 ± 11 years (mean ± standard deviation) and a male/female ratio of 1/3. Risk factors associated with drug non-adherence were: (i) male sex [adjusted odds ratio (AOR) = 2.5, 95% confidence interval (CI) (1.26–5.10)]; (ii) monthly income per household &lt;150$ [AOR = 4.47, 95% CI (1.22–16.34)]; (iii) monthly income per household 150–200$ [AOR = 4.44, 95% CI (1.04–18.93)]; (iv) bad relationship with the healthcare system [AOR = 2.17, 95% CI (1.29–3.67)]; and (v) uncontrolled blood pressure [AOR = 1.87, 95% CI (1.15–3.02)].

Conclusion
The prevalence of drug non-adherence is general among hypertensive patients in Meknes. Prevention should: (i) ensure the availability of adequate stocks of the anti-hypertensive drug at the PHCF; (ii) secure sufficient drug stocks to treat the poorest patients first; and (iii) improve blood pressure control in patients.
Relationship quality, dyadic coping, and depression in couples with left ventricular assist device implantation
Authors: Zimmermann Tanja , Dolle Samira , Waldenburger Nina , Jünemann Finja , Bara Christoph 
Published: January 2021

Abstract

Aims
Living with a left ventricular assist device (LVAD) can be associated with many burdens and worries for patients. They are often dependent on the support of their spouses. This can also be a burden on the spouses and the relationship. However, the relationships quality of LVAD couples has so far scarcely been investigated. Couple’s mutual coping with stress (dyadic coping, DC), as well as depression are important factors influencing relationship quality. To examine patients’ with an LVAD and their partners’ ability to cope with stress and levels of depression, and the impact these have on relationship quality.

Methods and results
The study investigates relationship satisfaction in couples after LVAD implantation as well as influencing factors such as DC or depression. Differences in relationship quality, DC, and depression between patients and spouses are examined using validated questionnaires. N = 39 heterosexual couples with male patients participated. Relationship quality of patients was higher than that of their spouses. The actor–partner–interdependence model provided for spouses actor effects on relationship satisfaction of their own DC, partner DC, and depression. For patients, actor effects of partner DC and depression as well as a partner effect of depression were found. In addition, DC of patients was estimated by both partners to be lower than DC of spouses.

Conclusion
The results indicate a high rate of depression among LVAD patients and spouses. This study contributes to the knowledge about the mental state of LVAD couples and demonstrates that the spouses should be considered during treatment.
Frequent nightmares and its associations with psychological and sleep disturbances in hospitalized patients with cardiovascular diseases
Authors: Horie Haruaki , Kohno Takashi , Kohsaka Shun , Kitakata Hiroki , Shiraishi Yasuyuki , Katsumata Yoshinori , Hayashida Kentaro , Yuasa Shinsuke , Takatsuki Seiji , Fukuda Keiichi 
Published: January 2021

Abstract

Aims
Frequent nightmares can pose a serious clinical problem, especially in association with sleep and psychological disturbances, in the general population. However, this association has not been investigated in inpatients with cardiovascular (CV) diseases. Furthermore, whether CV medications could induce iatrogenic nightmares remains unknown. In a cross-sectional designed study, we evaluated the prevalence and determinants of frequent nightmares and its association with sleep and psychological disturbances among hospitalized CV patients.

Methods and results
A total of 1233 patients (mean age, 64 ± 15 years; 25.1% female) hospitalized for various CV diseases in a single university hospital were enrolled. We assessed nightmares and sleep characteristics using the Pittsburgh Sleep Quality Index (PSQI), sleep-disordered breathing (SDB) using nocturnal pulse oximetry, and psychological disturbances using Hospital Anxiety and Depression Scale (HADS). Overall, 14.8% and 3.6% of the patients had at least one nightmare per month and per week (frequent nightmares), respectively. In this cohort, 45.9% had insomnia (modified PSQI &gt; 5), 28.0% had SDB (3% oxygen desaturation index &gt; 15), 18.5% had depression (HADS-depression ≥ 8), and 16.9% had anxiety (HADS-anxiety ≥ 8). Frequent nightmares were not associated with CV medications and SDB but were associated with depression [odds ratio (OR) = 4.61, 95% confidence interval (CI) = 2.03–10.48], anxiety (OR = 5.32, 95% CI = 2.36–12.01), and insomnia (OR = 7.15, 95% CI = 2.41–21.22).

Conclusions
Frequent nightmares were not uncommon in patients hospitalized for CV diseases. Although the cause–effect relationship is unclear, frequent nightmares were associated with psychological disturbances and insomnia, but not iatrogenic factors, among hospitalized CV patients. Cardiologists should be more conscientious to nightmare complaints with respect to screening for psychological disturbances and insomnia.
Flash mob studies: a novel method to accelerate the research process
Authors: Moons Philip 
Published: January 2021

Abstract
Because the time between study conception and dissemination of findings generally takes long, efforts to reduce this lag are important. A solution to accelerate the research process can be found in flash mob research. This is a method to study clinically relevant questions on a large scale in a very short course of time. The research question and the set-up of the study should be exciting. Doing so, it attracts a large ‘mob’ of people who collect the data. Consequently, the generalizability of flash mob studies may be higher than that of traditional research studies.
Impact of area deprivation on the cardiac mortality in the UK between1991 and 2010: evidence from a population-based longitudinal study
Authors: Jin Kai , Neubeck Lis , Atherton Iain 
Published: January 2021

Abstract

Aims
Evidence from longitudinal studies on the influence of area deprivation in cardiac mortality is limited. We aimed to examine the impact of area deprivation on cardiac mortality in a large representative Scottish population. We also examined differences between women and men.

Methods and results
Retrospective analysis was performed by using linked data from Scottish Longitudinal Study from 1991 to 2010. The main exposure variable was socioeconomic status using the Carstairs deprivation scores, a composite score of area-level factors. Cox proportional-hazards models were constructed to evaluate the hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiac mortality and all-cause mortality associated with area-based deprivation. Subgroup analyses were stratified by sex. In a representative population of 217 965 UK adults, a total of 58 770 deaths occurred over a median of 10 years of follow-up period. The risk of cardiac mortality and all-cause mortality showed a consistent graded increased across the deprived groups. Compared to the least deprived group, the adjusted HR of cardiac mortality in the most deprived group was 1.27 (1.15–1.39, P &lt; 0.000). There was strong evidence that women from more deprived areas had significantly higher cardiac death risk than those from the least deprived areas (HR 1.42, 95% CI 1.22–1.65), while this observation was not strong in men with same background.

Conclusion
Our study demonstrated area deprivation was the strong predictor of long-term cardiac mortality and all-cause mortality. The inequalities were substantially greater in women from more deprived areas than men from the same background.
Delay in seeking medical care for worsening heart failure symptoms: predictors and association with cardiac events
Authors: Lin Chin-Yen , Hammash Muna , Miller Jennifer L , Schrader Melanie , Mudd-Martin Gia , Biddle Martha J , Moser Debra K 
Published: January 2021

Abstract

Aims
The association of delay in seeking medical care to subsequent cardiac events remains unknown in patients with worsening heart failure (HF) symptoms. The aims of this study were to (i) identify factors predicting care-seeking delay and (ii) examine the impact of care-seeking delay on subsequent cardiac rehospitalization or death.

Methods and results
We studied 153 patients hospitalized with an exacerbation of HF. Potential predictors of delay including demographic, clinical, psychosocial, cognitive, and behavioural variables were collected. Patients were followed for 3 months after discharge to determine time to the first cardiac rehospitalization or death. The median delay time was 134 h (25th and 75th percentiles 49 and 364 h). Non-linear regression showed that New York Heart Association functional class III/IV (P = 0.001), worse depressive symptoms (P = 0.004), better HF knowledge (P = 0.003), and lower perceived somatic awareness (P = 0.033) were predictors of delay time from patient perception of worsening HF to subsequent hospital admission. Cox regression revealed that patients who delayed longer (more than 134 h) had a 1.93-fold higher risk of experiencing cardiac events (P = 0.044) compared to non-delayers.

Conclusions
Care-seeking delay in patients with worsening HF symptoms was significantly associated with an increased risk of rehospitalization and mortality after discharge. Intervention strategies addressing functional status, psychological state, cognitive and behavioural factors are essential to reduce delay and thereby improve outcomes.
Self-care strategies and interventions needed in patients with heart failure: from patient perspectives—a qualitative study
Authors: Heo Seongkum , Moser Debra K , Lennie Terry A , Kim JinShil , Turrise Stephanie , Troyan Pattie J , Kang JungHee , Jones Holly J 
Published: January 2021

Abstract

Aims
Most patients with heart failure (HF) have symptoms. Poor self-care has been associated with the development or worsening symptoms. Thus, to improve HF symptoms, it may be critical to understand self-care and interventions targeting improvements in HF symptoms needed from patients’ perspectives. To explore patients’ perceptions of self-care strategies of individual symptoms, HF symptom improvement, and interventions needed to improve HF symptoms in patients with HF.

Methods and results
Qualitative data were collected from 20 patients with HF using a semi-structured open-ended interview guide. Data were analysed using content analysis. Five themes appeared: (i) use of a variety of strategies with some knowledge deficit and inefficiency, (ii) uncertainty in symptom improvement, (iii) consideration of several possible self-care strategies, (iv) use of situation-specific strategies in seeking treatment, and (v) willingness to receive comprehensive and realistic interventions. Patients used a variety of self-care strategies, including taking medication, reducing activities, and changing diet and position, but many reported having a lack of knowledge and multiple HF symptoms. Several patients were uncertain whether symptoms could be improved, but all patients reported that they would participate in comprehensive and realistic intervention sessions to gain knowledge about their symptoms and management strategies, and to receive emotional support from healthcare providers and peer patients.

Conclusion
Patients with HF used several self-care strategies with the hope of symptom improvements but were uncertain about the effectiveness. More effective, comprehensive, and realistic interventions need to be delivered to patients with HF to enhance their ability to manage their symptoms.