bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective study of characteristics and burden of heart failure in Thailand: an interim analysis
Authors: Jiampo P , Boonyapiphat T , Torpongpun A , Senthong V , Pongmesa T , Taepanich N , Tangkittikasem T 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Novartis (Thailand) Limited

Background/Introduction
Heart failure (HF) is a major health problem due to its significant prevalence, disease burden and cost, mainly driven by high rates of hospitalization and mortality. Although numerous studies have demonstrated HF burden in western countries, data on current burden of HF in Thailand are limited.

Purpose
To describe characteristics and burden of HF, in terms of HF subgroups, hospital visits/hospitalization from HF and mortality, in participating hospitals in Thailand in 2019.

Methods
We retrospectively reviewed hospital profiles and medical records of HF adult patients at the five study sites which located in different regions across Thailand. All patients were diagnosed (newly and existing) with HF during 2018-2019, as identified by the International Classification of Diseases (ICD)-10 coding "I50". The interim data cutoff was scheduled when 4,000 patients were included. Hospital burden and the patients’ clinical and outcome data were collected and analyzed with descriptive statistics.

Results
From 4,000 patients, a total of 2,826 patients had follow-up visits in 2019 and then included in this analysis. Most of them were female (51.8%) and the overall patients’ mean (SD) age was 67.6 (15.0). Among 1,668 patients with available baseline left ventricular ejection fraction (LVEF), HF with preserved EF (HFpEF) was the most common subgroup (47.3%), followed by HF with reduced EF (HFrEF (39.0%) and HF with mid-range EF (HFmrEF) (13.7%). Of the total hospital visits from HF, 11.5% (95% CI 10.8-12.3) were from unscheduled visits to emergency or outpatient departments. HFpEF accounted for the highest number of hospital visits for HF, both scheduled and unplanned visits (46.4%, 48.9%), followed by HFrEF (39.0%, 41.5%) and HFmrEF (14.6, 9.6%), respectively. Among these 2,826 HF patients, the numbers of hospitalizations and rehospitalization from HF were 2,553 and 447. The total rate of HF rehospitalization was highest at 30 days (39.1%, 95% CI 34.6-43.7), followed by at 180 days (26.8%, 95% CI 22.7, 30.9), and 60 days (23.5%, 95% CI 19.6-27.4), respectively. The rates of all-cause and CV deaths within identified HF patients were 8.6% (95% CI 7.6-9.7) and 7.2% (95% CI 6.3-8.2). HFrEF accounted for the highest proportions of both (re) hospitalization and deaths (all-cause and CV) while HFpEF had the highest number of total beds.

Conclusion
Among the studied patients, HFpEF was the most common form of HF and HF was associated with a substantial healthcare burden in Thailand. The hospitalization rates from HF were especially high during the first 30 days after discharge, with a number of visits being unplanned or emergency visits leading to high hospital resource utilization.
Effects of SGLT2 inhibitors on heart failure symptoms, quality of life and exercise capacity in patients with heart failure and preserved ejection fraction: A meta-analysis
Authors: Merin L R C , Inso C A 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Patients with HFpEF usually have severe exercise intolerance which leads to poor quality of life. While SGLT2 inhibitors in HFrEF patients have been proven beneficial, with HFpEF it remains uncertain. This meta-analysis aimed to determine the outcomes of heart failure symptoms, exercise capacity, and quality of life in patients on SGLT2 inhibitors.

Methods
The studies included only RCTs. Eligible studies were appraised using the CASP RCT Standard Checklist. Outcomes expressed as mean difference (MD) between placebo group and SGLT-2 inhibitors group after 12 weeks in the Kansas City Cardiomyopathy Questionnaire Total Summary Score (KCCQ-TSS), Clinical Symptoms score (KCCQ-CS), Overall symptoms score (KCCQ-OS) and 6-minute walk test distance (6MWTD) were the main effect measures.

Results
Three RCTs with a total of 6,617 HFpEF patients were included in this meta-analysis. The patients on SGLT2-inhibitors showed improvement of HF symptoms and Quality of life based on KCCQ-TSS 2.68 (95% CI 0.78, 4.57), KCCQ-CS MD 2.60 (95%, CI 1.56, 3.63), KCCQ-OS MD 2.18 (95% CI 0.56, 3.8) and exercise capacity assessed by the 6-MWTD with MD 17.47 (95% CI 6.46, 28.48).

Conclusion
This meta-analysis showed that there was significant improvement in the heart failure symptoms, Quality of life and exercise capacity in patients taking SGLT2 inhibitors.
Real-world comparison of intracoronary imaging and fractional flow reserve measurements on outcomes of semi-urgent and elective percutaneous coronary intervention in a multi-ethnic asian population
Authors: Soh Y H R , Teo Y N , Teo Y H , Djohan A H , Ho S Y J , Sukmawati I , Chan K A , Sim H W , Yeo T C , Tan H C , Chan Y Y M , Sia C H 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Intracoronary imaging and fractional flow reserve measurements (FFR) are helpful in optimisation of percutaneous coronary intervention (PCI) for patients with stable coronary artery disease, but their comparative efficacy is not well described. Furthermore, few studies involve Asian patients in a real-world context.

Purpose
This study aims to compare the use of intracoronary imaging and fractional flow reserve measurements on the outcomes of semi-urgent and elective PCI in a multi-ethnic Asian population.

Methods
This was a retrospective database study of patients who underwent semi-urgent and elective PCI from 1st Jan 2014 to 31st Dec 2015 at a tertiary academic centre. The patients were split into 2 groups – imaging-guided (IG) consisting of intravascular ultrasound guided PCI or optical coherence tomography guided PCI and physiology-guided (PG) which included FFR-guided PCI. Patients who underwent both IG PCI and PG PCI were excluded. Incidence rates of major adverse cardiovascular events (MACE) (Subsequent myocardial infarction, congestive cardiac failure, all-cause mortality) and major adverse cardiovascular and cerebrovascular events (MACCE) (Subsequent myocardial infarction, congestive cardiac failure, stroke or transient ischemic attack and all-cause mortality) were compared between the two groups. One-to-one propensity score matching (PSM) was performed to control for potential bias.

Results
Of 1,732 patients studied, the median age was 61.0 years (IQR 53.0 to 68.0) and 336 were female (19.4%). There were 266 patients (15.4%) in IG and 186 (10.7%) in PG. The patients were followed up for 33 ±37 months. A total of 133 pairs were matched. In the unmatched cohort, there was no statistical difference between the IG and PG group in the incidence of MACE (24.2% vs 15.5%, p= 0.099) and MACCE (26.6% vs 17.7%, p= 0.112). Baseline and procedural characteristics were balanced between the IG and PG groups. In the matched cohort, the incidence rates of MACE (11.3% vs 7.5%, p= 0.383) and MACCE (15.8% vs 12.8%, p=0.596) did not differ significantly between the two groups.

Conclusion
In a real-world multi-ethnic Asian registry of semi-urgent and elective PCI patients, there was no difference in outcomes whether patients underwent the use of intracoronary imaging or fractional flow reserve measurements during PCI.
Association between ACE I/D gene polymorphism and coronary artery lesion characteristics in patients with acute myocardial infarction
Authors: Tran Cong D , Le Gia Hoang L , Do Duc M , Thai Thanh T , Hoang Van S , Truong Quang B 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Acute myocardial infarction (AMI) remains a public health issue with high morbidity and mortality rates and significantly reduces patients' health-related quality of life. The identification of factors influencing coronary artery lesion characteristics in patients with AMI can contribute to the strategy of primary and secondary prevention for AMI.

Purpose
This study was aimed to investigate the ACE I/D genotype rate and its relationship with coronary artery lesion characteristics in AMI patients.

Methods
This study was conducted with the prospective cross-sectional method among AMI patients admitted to the Department of Cardiology and Department of Interventional Cardiology, Cho Ray Hospital from January 1, 2020 to June 30, 2021. The minimum sample size of this study was 163 patients. The ACE I/D genotype was determined at the Center for Molecular Biomedicine.

Results
During the study period, a total of 522 AMI patients were recruited at the Department of General Cardiology and Department of Interventional Cardiology. The mean age of the AMI patients was 63.9±11.7 and the age group 45-64 accounted for the most (46.4%). Males were predominant (71.5%). The patients' median Gensini score was 34.3. The II, ID and DD genotype rates of ACE I/D polymorphism were 48.9%, 36.4%, and 14.7% respectively. The ACE DD genotype was not associated with the location and number of diseased coronary arteries but was associated with the severity of coronary artery disease. Multivariable linear regression analysis showed that along with the Killip class, the ACE DD genotype was independently associated with a higher Gensini score compared with the II or ID genotype.

Conclusions
This has been the first study in Vietnam demonstrated the association between ACE I/D gene polymorphism and coronary artery lesion characteristics in patients with AMI. The ACE I/D gene polymorphism may be considered for testing to contribute to the comprehensive assessment and aggressive treatment of AMI patients.
Association between body mass index (BMI) and severity of coronary artery disease in young onset acute coronary syndrome (ACS)
Authors: Moniruzzaman M , Koli A , Malik F , Islam S 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
A high body mass index (BMI) is seems to be associated with an increased incidence of coronary artery disease. If the affected person is young, the consequences are more tragic. There are variable information on the relation of incidence and severity of coronary artery disease in high BMI populations. We have examined the association between BMI and severity of coronary artery disease in young onset Acute Coronary Syndrome (ACS).

Methods
In this prospective observational study a total number of 150 patients, aged ≤45 years presented with acute coronary syndrome were enrolled to analyze association between Body Mass Index (BMI) and severity of coronary artery disease.

Results
The mean BMI in male was 24.6±3.6 and the mean BMI in female was 25.4±3.3. Among the 150 patients, 2(1.3%) was underweight, 78(52%) was normal, 60(40%) was overweight & 10(6.7%) was obese. All underweighted patients were diagnosed as STEMI. Among the normal BMI patients, 18(23.1%) had UA, 12(15.4%) had NSTEMI & 48 (61.5%) had STEMI. Among the overweight patients, 23(38.3%) had UA, 9(15%) had NSTEMI & 28(46.7%) had STEMI. And among the obese patients, 4(40%) had UA, 1 (10%) had NSTEMI & 5(50%) had STEMI. Considering involving coronary artery, left main coronary artery involvement was 0(0%), 6 (7.7%), 5 (8.3%) & 0(0%) in underweight, normal, overweight & obese patients respectively. Left anterior descending coronary artery involvement was 2(100%), 54 (69%), 45 (75%) & 7 (70%) in underweight, normal, overweight & obese patients respectively. Left circumflex coronary artery involvement was 1(50%), 33 (42%), 25 (41.7%) & 1 (9%) in underweight, normal, overweight & obese patients respectively. And right coronary artery involvement was 1(50%), 35 (44.9%), 31 (51.7%) & 5 (50%) in underweight, normal, overweight & obese patients respectively. In underweight patients 1(50%) had SVD and 1 (50%) had TVD. In normal BMI patients 40 (51.3%) had SVD, 11(14.1%) had DVD and 19 (24.4%) had TVD. In overweight patients 27 (45%) had SVD, 15 (25%) had DVD and 13 (21.7%) had TVD. And in obese patients 5 (50%) had SVD, 3(30%) had DVD and 0 (0%) had TVD. In all BMI group SVD was more common.

Conclusion
There is no statistically significant differences in severity of coronary artery in respect to body mass index (BMI), in patients presented with acute coronary syndrome.
Preliminary results of whole exome sequencing in a clinical hypertrophic cardiomyopathy cohort in India
Authors: Chockalingam P , Thenral S G , Ramprasad V , Anantharaman R 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Hypertrophic cardiomyopathy (HCM), characterized by unexplained left ventricular hypertrophy and outcomes ranging from normal life expectancy to heart failure and sudden cardiac death, has a global prevalence of about 1 in 500. Genetic testing helps to improve care of patients with HCM and their family members as children of carriers have a 50% chance of inheriting the disease. However, there is limited availability, awareness and application of genetic testing modalities, particularly whole exome sequencing (WES), in the management of HCM in India.

Purpose
This study aimed to analyze the results of WES in a clinical HCM cohort in India.

Methods
Patients with unexplained moderate to severe cardiomyopathy presenting to our centre from 2017 to 2022 and consenting for genetic testing were included in the study. Following a thorough clinical diagnostic process including 3-generational family history, electrocardiogram and echocardiogram in all patients and exercise stress test, Holter monitoring and cardiac magnetic resonance imaging where applicable, pre-test counseling was provided and WES performed using genomic DNA isolated from whole blood samples. A total of 33 affected individuals including 1 affected family member from 32 families were processed for genetic testing. A multidisciplinary team comprising of cardiologist, cardiothoracic surgeon, physician with expertise in cardiogenetics, geneticist and genetic counselor carried out the study in a tertiary cardiac centre.

Results
Age of the probands (n=32) at the time of the study was 47.8±15.9 years and 24 (75%) were males. There was concomitant hypertension in 11 (34%), type 2 diabetes mellitus in 6 (19%), arrhythmias in 6 (19%) and coronary artery disease in 2 (6%) probands. Obstructive HCM was present in 2 (6%) probands. Disease-causing significant variants (Pathogenic/Likely pathogenic) were detected in 8 (25%, Table), variants of uncertain significance in 17 (53%) and no significant variants were detected in 7 cases. Cascade genetic testing of significant variants among 7 family members of 4 probands showed segregation of the pathogenic variant in 4 asymptomatic carriers.

Conclusions
The yield of whole exome sequencing in a clinical HCM cohort in India was 25%. Of note the rare variants of uncertain significance in the cardiomyopathy genes makes genetic counseling and disease management challenging. However, large-scale studies in the context of Indian population are expected to bring clarity on the role of these variants in disease manifestation. A multidisciplinary team approach incorporating genetic testing modalities such as whole exome sequencing and cascade screening is the way forward in the comprehensive management of patients with HCM and their families.
Correlation of Echoradiography Pulmonary to Left Atrial Ratio (ePLAR) with Right Heart Catheterization Parameters in Pulmonal Arterial Hypertension
Authors: Fernando H , Yanni M , Hariyanto D 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Until now, right heart catheterization is still the gold standard for pulmonary hypertension examination, but this examination is invasive, has a risk of action, and is limited. Echocardiography provides an alternative examination that is easier, safer, cheaper, and more effective in evaluating pulmonary hypertension. Various echocardiographic parameters have been used to assess pulmonary hypertension but no parameter can distinguish the hemodynamics of pulmonary hypertension. Echocardiography pulmonary to left atrial ratio (ePLAR) is a new echocardiographic parameter that is formulated by the maximal tricuspid regurgitation velocity (TR Vmax) divided by the mitral E/e'. This simple parameter can determine precapillary pulmonary hypertension

Purpose
The aim of this study is to determine the correlation of ePLAR with right heart catheterization parameters in pulmonary arterial hypertension patients.

Methods
This is a cross-sectional study in the pulmonary arterial hypertension group conducted at M. Djamil Hospital from August 2021 to May 2022. Respondents underwent an echocardiography and right heart catheterization prosedure. The correlation of ePLAR with right heart catheterization parameters was assessed using the Spearman correlation test.

Result
The research subjects were 32 patients with pulmonary arterial hypertension, 20 women and 12 men, the median age was 21.50 (8-54) years and the most common cause of pulmonary arterial hypertension was congenital heart disease. The median value of ePLAR was 0.44(0.30-0.77) m/s, while the mean value of mPAP was 54.40 ± 16.24 mmHg and the median value of PVR was 8.39 (3.21-29.50) WU. Based on the Spearman correlation test, it was found that the ePLAR had a moderate positive correlation (r=0.554) with the mPAP and was statistically significant (p=0.001). The ePLAR had a strong positive correlation (r=0.779) with the PVR and was statistically significant (p&lt;0.001)

Conclusion
There was a moderate and significant positive correlation between ePLAR and mPAP, there was a strong and significant positive correlation between ePLAR and PVR in patients with pulmonary arterial hypertension.
Ambient heat exposure after the rainy season is associated with an increased risk of Stroke
Authors: Fujimoto R , Suzuki E , Kashima S , Kazufumi N , Oka T , Ito H , Yorifuji T 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Stroke is a major global health issue and Climate change is the biggest and most urgent challenges. The Asia and Pacific region have been more vulnerable to climate change and extreme heat exposure than other regions of the world. Despite the growing concern for heat waves, few studies have investigated heat exposure and the risk of Stroke in the elderly considering effect of Asian meteorological factors.

Purpose
We aimed to examine the association between heat exposure and the risk of Stroke in the elderly and to evaluate possible effect-measure modifications by the rainy season, which is a characteristic climatic occurrence in East Asia.

Methods
Our study was designed as a time-stratified case-crossover. The study included 3367 residents in the city, Japan, aged 65 years or older who were dispatched to emergency hospitals between 2012 and 2019 for the onset of Stroke during and a few months after the rainy seasons (Picture 1). We examined the association between temperature and Stroke onset during and a few months after the rainy seasons with conditional logistic analysis adjusted for relative humidity, barometric pressure, and particulate matter less than 2.5 µm in diameter (pm 2.5). Furthermore, we examined analyses on effect-measure modification where is the exposure of a 1°C increase in temperature and potential effect modifier as stratified during and after the rainy seasons.

Results
Heat exposure during one month after the rainy season was associated with Stroke risk; the adjusted odds ratio (OR) for a 1°C increase in temperature was 1.34 (95% confidence interval [CI]: 1.29-1.39). In stratified type of the stroke, Hemorrhagic stroke (OR: 1.37, 95% CI: 1.24-1.51), Ischemic stroke (OR: 1.37, 95% CI: 1.24-1.53), and Transient ischemic attack (OR: 1.43, 95%CI: 1.23-1.68) were significantly associated with heat exposure during one month after the rainy season respectively (Picture 2). In the results of analyses on effect modification, one month after the rainy season group was highest than other groups when reference was during the rainy seasons (OR: 1.34, 95% CI: 1.3-1.39, P&lt;0.001 [Measure of effect modification on additive scale]).

Conclusions
The present study suggests that heat exposure increases the risk of Stroke onset during the month after the end of the rainy season in the elderly. We propose that public health measures, such as maintenance designed high-insulated housing and improved air conditioning control, be implemented in the Asia and Pacific region to address heat exposure during one month after the rainy season, which can affect the incidence of stroke in the elderly.
Modified STEMI protocol for Primary PCI during COVID-19 Pandemic:Does it prolong Door-To-Balloon performance?
Authors: Putranto A Y , Haykal Putra T M , Soedarsono W A 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private hospital(s). Main funding source(s): Jakarta Heart Center

Background
COVID-19 became a main health problem and causes heavy impact, especially for healthcare system. Managing ST-Segment Elevation Myocardial Infarction (STEMI) patients before COVID-19 pandemic was already challenging enough for Healthcare Professionals (HCP) to pursue time-sensitive treatment. After COVID-19 pandemic, the time-sensitive treatment of pursuing door-to-balloon (DTB) time put a lot more burden to HCP. In this study, We sought to analyze how a change in protocol of Primary PCI (PPCI) in STEMI patients before and during the pandemic influence the performance of DTB in the hospital.

Methods
This is a single-centered retrospective observational study among STEMI patients which was treated by PPCI. Secondary data from the medical record were collected consecutively from April 2018 to January 2022 (46 months). We compared DTB performances before and during the pandemic.

Result
During 46 months period, the total population of this research was 880 patients. There were total 358 patients underwent PPCI before the pandemic and 522 patients after the pandemic. Modified protocol with the addition step to prevent the spread of COVID-19 had been implemented since April 2020. DTB increased significantly during the pandemic (90 (70-124) minutes vs 97 (76-135) minutes, p 0.002). The proportion of the patients who achieved DTB under 90 min was also significantly decreasing (56.4% vs 47.9%, p 0.0013).

Conclusion
It is necessary for PPCI center to modify PPCI workflow during the pandemic. A decent workflow should consider practicality and simplicity without compromising HCP and patient safety. Implementing modified PPCI workflow during the pandemic significantly increased DTB time but it is still within the limit of being reasonable and acceptable for the benefit of the patients.