bluuebunny/crossref_metadata_2025_split huggingface dataset:
Falls among patients with hypertension - preliminary study
Authors: Swiatoniowska-Lonc N , Jaciow E , Polanski J , Jankowska-Polanska B 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. Falls among the elderly are a major cause of injury, significant disability and premature death. Hypotension is a potential risk factor for falls in older adults, especially patients with hypertension (HTN) taking antihypertensive drugs. Furthermore, the cardiovascular benefit of treatment of hypertension in older patients is clear, findings from observational studies have raised concerns that antihypertensive therapies in the elderly might also induce adverse effects, including injurious falls. In spite of the large number of issues related to this topic, the analysis of the causes of falls is insufficient.
The aim of the study was to assess the frequency of falls and the impact of selected variables on the occurrence of risk of falls among patients with HTN.
Material and methods. 100 patients, including 55 women, with HTN (mean age 69.4 ± 3.29 years) were enrolled into the study. The Tinetti test was used to assess the risk of falls. Sociodemographic and clinical data were obtained from the hospital register.
Results. 89% of patients had a high risk of falls and 11% were prone to falls. The average number of falls during the last year in the study group was 1.86 ± 2.82 and in 30% of cases the fall was the cause of hospitalization. Single-factor analysis of the influence of selected variables on the risk of falls showed that higher values of SBP (-0.27; p = 0.007), DBP (-0.279; p = 0.005) and younger age of patients decrease the risk of falls (-0.273; p = 0.006). The linear regression model showed that independent predictors increasing the risk of falling are: use of diuretics (β=4.192; p &lt; 0.001), co-occurrence of ischemic heart disease (β=4.669; p = 0. 007) and co-occurrence of heart failure (β=3.494; p = 0.016), and predictors reducing the risk of falling patients with hypertension are: the use of beta-blockers (β= -4.033; p = 0.013) and higher DBP value (β= -0.123; p = 0.016).
Conclusions. Patients with HTN have a high risk of falling. Independent determinants increasing the risk of falling patients with HTN are the use of diuretics and the co-occurrence of ischemic heart disease or heart failure, while beta-blockers and a higher DBP value are factors reducing the risk of falling. Fall risk assessment and implementation of fall prevention should be carried out in everyday practice.
Telemedicine reduces long term mortality in patients with heart failure with reduced ejection fraction
Authors: Koulaouzidis G , Charisopoulou D 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Telemonitoring was introduced with the potential to improve the medical care, quality of life and prognosis of patients with heart failure (HF). The aim of the study was to assess the effect of home telemedicine (HTM) in long-term mortality in patients with heart failure with reduced ejection fraction (HFrEF).

Methods
This is a retrospective study of 452 consecutive subjects with HFrEF who were referred to HTM service. The HTM service was offered to HFrEF patients who: a) have been recently diagnosed with HF, b) have been recently hospitalized due to HF, c) have worsening HF, d) need frequent medication changes, e) are NYHA class II or III.
Most patients (n= 352) accepted HTM (HTM-group), but 100 patients refused and received the usual care (UC-group). The HTM group were assessed daily by body weight, blood pressure and heart rate using electronic devices with automatic transfer of data to an online database. A nurse practitioner evaluated the measurements every day using a dedicated clinical user interface. Clinical alerts are dealt with by the HTM nurse calling the patient and then, if necessary, a clinical responder; either a community HF nurse with prescribing qualifications or a cardiologist if long-term changes in therapy are required. Patients in both groups were seen at a specialist HF clinic and the frequency of clinical follow-up was at the discretion of the HF team. The same cardiologists reviewed the patients in both groups. Follow-up period was 60 months.
Higher prevalence of male gender was seen in the UC-group (78% vs 67%, p = 0.03). Otherwise there was no significant difference in the demographic characteristics or primary cause of HF between the two groups. Also no differences were seen between the two groups in the treatment with beta blockers, angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers and aldosterone antagonists.

Results
The mean follow-up period for survivors was significantly higher in HTM-group compared with UC-group (50.6 ± 18.2 vs. 37.8 ± 25.2, p &lt; 0.001). After 3 month of follow-up, the all-cause mortality was significantly lower in HTM-group than in UC-group (2.8% vs. 14%; p &lt;0.01). This significantly lower mortality in HTM-group compared to UC-group was further observed in 6 months follow-up ( 4.5% vs. 22%, p &lt; 0.0009); in 12 months follow-up (9% vs. 31.2%, p &lt; 0.0002); in 18 months follow-up (13.4% vs. 38.2%, p &lt; 0.0001); in 24 months follow-up (15.1% vs. 42%, p &lt; 0.0001); in 36 months follow-up (19% vs. 44.5%, p &lt; 0.0002); in 48 months follow-up (23% vs. 46%, p &lt; 0.001); and finally in 60 months follow-up (25.3% vs. 46%, p &lt; 0.003).

Conclusion
HTM was associated with improved survival. This was observed from the first months of the study and remained present until the end of the study.The reduced mortality in the HTM patients may reflect the fact that HTM improves patient HF knowledge and self-care behaviors.
Bridging the gap from hospital discharge to cardiac rehabilitation using the intervention mapping approach (BRIDGE2CARE)
Authors: Keessen P , Van Duijvenbode ICD , Latour CHM , Kraaijenhagen RA , Janssen V , Jorstad HT , Scholte Op Reimer WJM , Visser B 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Dutch Research Council

INTRODUCTION
Cardiac rehabilitation (CR) is the cornerstone of secondary prevention. After hospital discharge, patients have to wait for participation in CR while often feeling overwhelmed by their cardiac event and in need of tailored information and support.

PURPOSE
The objective of this study was to develop a remote (digital) intervention to bridge the gap from hospital discharge to CR.

METHODS
We developed an intervention by completing the first three steps of the intervention mapping protocol. Step 1: identification of information- and support needs from the literature and semi-structured interviews. Step 2: Describing performance objectives for the intervention and selecting determinants. Step 3: Generation of program themes and theory based change methods.

RESULTS
(Step 1) The following Information- and support needs were identified from the literature (n = 33) and semi structured interviews (n = 22): information about pathology and intervention, medication and side effects, daily physical activities, psychological distress, body signals and social support. Advanced communication and pedagogical skills of the health care provider and the ability to build trust were described as important prerequisites for the intervention. (Step 2) The following performance objectives were formulated: (1) Patients gain knowledge on how their cardiac illness and procedure affects their bodies and health, (2) Patients gain knowledge about medication and side effects, (3) Patients know which daily physical activities they can and can’t do after hospital discharge and are physically active, (4) Patients and informal caregivers can deal with psychological distress and know how to discriminate between harmful and harmless body signals. Objectives were described per determinant (knowledge, skill, attitude, social influence, self-efficacy and outcome expectation). (Step 3) A comprehensive remote intervention was developed using theory based coaching strategies, a digital patient platform and information videoclips.

CONCLUSION
This study describes the information and support needs of patients after cardiac hospitalization and offers a remote intervention that bridges the gap form hospital discharge to CR.
Abstract Figure. BRIDGE2CARE
The role of the novel MyAlgos e-medicine Platform in promoting patient-centered self-care management in patients with atrial fibrillation: The emPOWERD trial
Authors: Lazaridis C , Mouselimis D , Bakogiannis C , Tsarouchas A , Antoniadis A , Papadopoulos CE , Tzikas S , Fragakis N , Vassilikos VP 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background
The emergence of digital health has revolutionized most aspects of healthcare. Meanwhile, atrial fibrillation (AF) remains the most common sustained arrhythmia associated with high morbidity and impaired quality of life. Patient-perceived treatment burden can be further optimized by digital health interventions utilizing smartphone technology.
The MyAlgos platform is an integrated software system designed to enhance the remote management and communication between the patient and the healthcare practitioner. The mobile application encourages patient self-management through educational modules and tools to improve medication adherence. The web-based platform allows the health care practitioner to receive live updates on patient status and design personalized self-care management plans.
Purpose
To investigate whether the use of the MyAlgos platform by AF patients is safe and improves the quality of self-care, quality of life (QoL), and hospitalization rate.
Methods
We designed a single-center, randomized, controlled, prospective, open-label, pilot study to compare the effect of the use of the full-feature MyAlgos platform version versus a stripped-down control version of the platform on the QoL, medication adherence and hospitalization rate in patients with paroxysmal AF. The full version of the e-medicine platform includes active patient education, communication with the medical team, medication reminders as well as the full record of clinically significant data such as heart rate and blood pressure. Specialized algorithms monitor patient data and alert physicians for potential AF episodes. The control version only allows the recording of patient’s heart rate.
Results
A total of 80 patients with paroxysmal AF were randomized in a 1:1 ratio to receive either the full or the control version of the MyAlgos Platform. The mean age of all patients, 53 (66%) male, was 58.1 ± 9.1 years. Hypertension and diabetes were present in 47 (59%) and 7 (9%) respectively. At baseline, the majority of patients had AF-related symptoms classified as European Heart Rhythm Association (EHRA) I (45%) or EHRA II (24%), while the mean Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) score was 70.1 ± 17.0. Between the two groups, there were no statistically significant differences in the baseline characteristics of the participants.

Conclusion
The emPOWERD trial will provide data on the impact of a novel e-medicine platform on the QoL, medication adherence and hospitalizations of patients with paroxysmal AF. We anticipate better outcomes for the subjects receiving the full version of the MyAlgos platform, allowing it to positively affect the further management of paroxysmal AF.
Abstract Figure. The MyAlgos e-medicine Platform
Design of an E-Health platform using artificial intelligence technologies for the surveillance and prevention of patients with cardiovascular diseases against covid19
Authors: Mouine N , Hilmani A , Maizate A , Mahmoudi C , Benyass A 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction
Covid-19 disease is caused by SARS-CoV-2.The symptomatology is variable, it can range from a common cold to a severe acute respiratory distress. Severe forms are mainly seen in patients with cardio vascular disease, they are at very high risk of mortality. The aim of our project is to design and producean E-Health platform to enable telemedicine acts such as telemonitoring and assistance of patients with cardio vascular disease to prevent covid 19 infection
Materials and methods
It is an e-health platform that uses digital technologies associated with artificial intelligence to provide remote monitoring and assistance to patients; It consists of two parts: the acquisition of patient data, a gateway and a central system. Acquisition of patient data by sensors equipped with a wireless data transmission device allowing the recovery of patient health indices such as heart rate, respiratory rate ..., a mobile application which allows to acquire data emitted by the sensors placed on the patient, which includes an AI module that analyzes the data in real time in order to send alerts to the patient Expected results
Through telemedicine, patients with cardiac diseases will be under continuous monitoring of hemodynamic parameters: Temperature, Arterial oxygen saturation, Heart Rate, Blood Pressure, Electrocardiogram ...,,these data will be processed by an AI module which will analyze the results and will detect anomalies. The latter will give recommendations and immediately alert the patient

Conclusion
Telemedicine is a new and innovative concept, it will improve the health care and will have a great socio-economic impact on bothpatient andhealth services. it"s can help to fight against Covid 19 infection.
Validity and trends of myocardial infarction incidence and case-fatality estimated from linked administrative databases
Authors: Camps-Vilaro A , Perez-Fernandez S , Elosua R , Subirana I , Palomo I , Sanchis J , Tizon-Marcos H , Vaquerizo B , Farre N , Sala J , Masia R , Ramos R , R Degano I , Marrugat J 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): CIBERCV of cardiovascular diseases; CIBERESP.

OnBehalf
REGICOR investigators

Background
Although myocardial infarction (MI) severity trends are systematically measured with mortality rates, MI incidence trends and the precision of its estimation by linkage of anonymized electronic databases are relatively untested. We validated a linked-data method (LDM) to estimate a population MI incidence and case-fatality, and to analyse the 1990-2016 trends in North-Eastern Spain.

Methods
LDM consisted of linking MI hospital discharges (n = 4,533,981) and mortality registry data (n = 40,676) for 2008-2016, selecting key MI diagnostic codes. The prospective REGICOR study, including all MI cases in Girona, 1990-2009, was used as the gold standard for validation purposes. Standardized MI cumulated incidence and 28-day case fatality for population aged 35-74 years was calculated, 1990-2016 trends were analysed by linear and joinpoint regression and annual percentage change (APC).

Results
LDM and REGICOR MI incidence and case-fatality estimates were similar for 2008-09 (Table). LDM MI incidence and case-fatality significantly decreased: APC 1990-2016 [95% CI]) was -1.8 [-2.6;-0.9] in women, and APC 2002-2016 -2.8 [-3.8;-1.8] in men; case-fatality APC 1990-2016 was -4.7% [-5.7;-3.8] in women and APC 1995-2005 -6.5%[-8.5;-4.5] in men.

Conclusions
LDM in population aged 35-74 reliably estimated MI incidence and case-fatality. MI incidence and case-fatality significantly decreased after 1990.
Comparative analysis of REGICOR vs LDM REGICOR 2008-2009 LDM 2008-2009 Estimate 95% CI Estimate 95% CI P-Value Cumulated incidence Men 245.4 228.3; 262.5 239.7 222.5; 256.3 0.626 Women 61.1 52.6; 69.6 58.2 49.9; 66.4 0.626 Overall 28-day case-fatality Men 23.5% 19.7; 27.2 21.3% 17.8; 24.9 0.422 Women 19.3% 6.7; 31.9 17.7% 6.3; 29.1 0.855 In-hospital case-fatality Men 6.9% 4.8; 9.0 5.7% 3.8; 7.6 0.394 Women 5.0% 1.9; 8.2 3.7% 1.0; 6.5 0.540 Pre-hospital case-fatality Men 16.5% 11.8; 21.3 15.6% 11.2; 20.1 0.791 Women 14.2 % 6.6; 21.9 14.0% 6.3; 21.7 0.961 CI Confidence Interval
Potentially inappropriate home medications among older patients with cardiovascular disease in a Moroccan population
Authors: Maaroufi A , Zahidi H , Abouradi S , Choukrani H , Habbal R 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background :
Patients with cardiovascular diseases use often multi-drugs regimen , which can often be associated with use of potentially inappropriate medications PIMs especially in elderly , which may pose more risks than benefits to patients and is a major factor contributing to the likelihood of serious adverse drug reactions and negative health outcomes among this population .

Methods
A Prospective study was conducted in a tertiary care hospital in Morocco where home medications of out patients were reviewed during follow-up consults and analyzed over three months, from October till December 2020. Inclusion criteria were age of 65 years and above, history of cardiovascular disease. The aim of our study was to determine the frequency and factors associated with PIMs, by applying the updated Beers 2015 criteria.

Results
A total of 214 patients were included in the study and were taking a total of 1498 medications at home, an average of 7 ± 3 medications per patient. The proportion of PIMS was 32 % of all medications reported, with an average of 2.2 PIM per patient, and 84% of patients were receiving at least one PIM.
Significant association was found between use of PIMs and number of home medications, female gender, self medication , and number and types of comorbidities.
Comorbidities associated with more PIMs were heart failure, atrial fibrillation/flutter, rheumatological diseases, cerebrovascular accident, and insomnia/depression . The most commonly prescribed PIMs were: drugs that may exacerbate or cause syndrome of inappropriate antidiuretic hormone secretion or hyponatremia (27.3%), NSAIDs use in patients under anticoagulants (21.2%) , use of proton pump inhibitors (PPIs) &gt; 8 weeks in non-high-risk patients (10.5%), and benzodiazepines (5.7%).

Conclusions
A high prevalence of PIMs in older patients with cardiovascular disease was observed. Health care giver’s education and detailed assessment of medication lists upon follow-up consults or hospital admission by multidisciplinary teams can help in preventing the use of PIMs.
Standardised quantification of coronary inflammation using cardiac computed tomography: The Fat Attenuation Index Score (FAI-Score)
Authors: Oikonomou EK , Schottlander D , Antonopoulos AS , Marwan M , Kotanidis CP , Kluner LV , Shirodaria C , Channon KM , Neubauer S , Desai MY , Deanfield J , Achenbach S , Antoniades C 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation

OnBehalf
the CRISP-CT study investigators

Introduction
Non-invasive detection of coronary inflammation has the potential to improve targeting of cardiovascular prevention strategies. Coronary computed tomography angiography (CCTA)-based fat attenuation indexing (FAI) is a novel, validated measure of coronary inflammation that captures spatial changes in perivascular fat composition induced by coronary inflammation. However, to ensure accuracy, FAI values must be carefully standardized for technical, anatomical and biological factors before they are introduced for risk stratification in clinical practice.

Purpose
To validate the prognostic value of FAI-Score, the output of a new, artificial intelligence (AI)-powered algorithm, that harmonizes the FAI values of each coronary artery to generate a standardized metric of coronary inflammation for clinical use.

Methods
The study included 3912 individuals from the CRISP-CT study (2040 from the United States and 1872 from Europe) with a mean age of 55.7 (± standard deviation 13.7 years), 1608 (41.1%) of whom were women; all underwent clinically indicated CCTA. FAI-Score was measured at baseline in the proximal right coronary (RCA), left anterior descending (LAD) and left circumflex arteries (LCX) using the CaRi-Heart V1.1 platform (panel A). Percentile curves were created for the FAI-score of the RCA, LAD and LCX across different age and sex strata. Their prognostic value was further assessed in Cox models adjusted for hypertension, hyperlipidemia, diabetes mellitus, smoking, high-risk plaque features and the modified Duke prognostic coronary artery disease index.

Results
Over a median follow-up period of 5.6 years there were a total of 74 cardiac deaths. FAI-Score percentile curves were created to provide a population reference map for FAI-Score phenotyping of the three main coronary territories; LAD (panels B, C), RCA and LCX. There was a stepwise association between higher FAI-Score percentiles and the prospective risk of cardiac mortality across all three vessels analysed. When compared to individuals below the 50th percentile, those in the 90th percentile or higher had a 3.5-fold (LAD, panel D), 5.5-fold (RCA, panel E) and 2-fold (LCX, panel F) higher adjusted risk of cardiac mortality.

Conclusion
Coronary FAI-Score percentile curves provide a reference map for coronary inflammatory burden and enable standardized interpretation of perivascular FAI mapping on CCTA. Individuals in the top percentile curves have an increased cardiovascular risk independent of traditional risk factors and existing atherosclerotic changes.
Abstract Figure.
New endothelial markers: implications for coronary artery disease and chronic periodontitis
Authors: Lipatova TE , Eremin AV , Lepilin AV 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
There is an association between chronic periodontitis (CP) and coronary artery disease (CAD). Endothelial function is increasingly used as an important outcome measure in cardiovascular diseases. But the data on early markers endothelial dysfunction in patients with CP is limited.
Aim. To determine whether there are differences in parameters of tissue endothelial markers in gingiva between patients with CP, CAD or CAD and concomitant CP.

Methods
We examined 30 patients with CAD, 75 patients with CP and 35 patients with CAD and concomitant CP and 25 healthy control. There were no differences between the groups of patients with CP, CAD and co-morbidity in age, gender, smoking and obesity. In marginal gingiva NO-synthase-like cells (NOs-cells) and marker of endothelial progenitor cells (CD34+ cells) by immunohistochemical and morphometric analyses were assessed. Endothelium-dependent vasodilation (EDV) of the brachial artery was evaluated.

Results
Immunoreactivity to NOs and the CD34+ cells was found mainly in the vascular. In patients with average and severe CP significant decrease of expression of NOs–cells (6.2 ± 2.4% vs 7.9 ± 1.9%, p &lt; 0.05) and of CD34+ -cells (6.3%±1.8 vs 8.9 ± 2.6%, p &lt; 0.05) in gingiva was detected. There were no differences of endothelial immunohistochemical markers between the groups of patients with mild CP and healthy person. In patients with CAD also significant decrease of expression of NOs–cells (5.0 ± 2.1%) and of CD34+ -cells (4.9%±2.0%) in gingiva was found. The most significance changes of gingival expression of NOs–cells (4.3 ± 1.4%) and of CD34+ -cells (3.8%±1.7%) in patients with CAD and concomitant CP were observed.
In the control group EDV 15.4 ± 6.5%, in patients with mild CP 13.9 ± 6.5, in patients with average and severe CP 10,9 ± 5,1% (p = 0.02 between healthy person). There were associations between the decrease of EDV of the brachial artery with gingival expression of NOs–cells and of CD34+ -cells (Spearman"s R = 0.575 and R = 0.578).

Conclusion
Average and severe periodontitis is associated with vascular effects outside the oral cavity. Periodontitis also as CAD are associated with changes in the cell expression of NOs and endothelial progenitor cells in the periodontal tissue. Immunohistochemical assessment of endothelial markers in periodontium is a promising method of early assessment of endothelial dysfunction in cardiovascular disease.