bluuebunny/crossref_metadata_2025_split huggingface dataset:
Malnutrition: a mascaraed and underused prognostic marker in coronary patients
Authors: Martinho A , Almeida J , Goncalves F , Monteiro S , Franco F , Goncalves L 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Malnutrition had been associated with worse prognosis in heart failure (HF) patients, especially in elder. However, this association wasn’t demonstrated in coronary patients, after a ST-segment elevation myocardial infarction (STEMI). We want to evaluate the prognosis value of malnutrition, in elder patients, after a STEMI.

Methods
We conducted a retrospective, observational study of 200 elderly patients (365 years) consecutively admitted with STEMI between 2016 and 2017. At discharge, we applied a validated formula who evaluate nutritional status: "Prognostic Nutritional Index" (PNI), [10 x serum albumin at discharge (g/dL) + 0.005 x total lymphocytes at discharge], whose lowest values were associated with malnutrition. At 1 year follow-up, we evaluated the relation between PNI and major adverse cardiac events (MACE): myocardial infarction (MI), HF hospitalization, cardiovascular (CV) and all-cause death.

Results
Mean age was 74±8 years, 71% (n=149) were male and with multiples risks factors (75% hypertense, 63% with dyslipidemia, 33% diabetes and 11% smokers). At discharge, patients had a mean Left Ventricular Ejection Fraction (LVEF) of 47±8% and a mean PNI of 37±5. Low PNI values (malnutrition) were significant associated with MACE at 1-year [OR 0.87 (95% CI 0.78 to 0.97, p=0.01)], after adjusting for age, sex and LVEF. When evaluated individually, low PNI was associated with more incidence of 1-year HF hospitalization [OR 0.88 (95% CI 0.78 to 0.99, p=0.03)] and all-cause death [OR 0.84 (95% CI 0.75 to 0.95, p=0.004)], after adjusting for age, sex and LVEF, but not with MI and CV death.

Conclusion
Malnutrion associated with other comorbidities inherent to elderly people were associated with MACE, 1-year after STEMI, in this type of population. Thus, we want to draw attention to the importance of evaluating the nutritional status during hospitalization for STEMI, allowing to initiate measures that contribute to its improvement.
A behavioural intervention to increase lay-people's intentions to initiate CPR in the event of Out-of-Hospital Cardiac Arrest: results from BICeP pilot trial
Authors: Farquharson B , Dixon D , Williams B , Clegg G , Macinnes L , Ramsay P 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Medical Research Council

Background
Cardiopulmonary resuscitation (CPR) is the single most important factor determining survival from out of hospital cardiac arrest (OHCA). Even when trained, most lay-people don’t attempt CPR when they encounter OHCA. Working closely with intended users and CPR experts we developed a theory-based text-messaging intervention designed to increase rates of CPR. This pilot study was conducted to evaluate the acceptability of the messages, explore participant responses to them and to trial measures for a full evaluation.

Design
A before-and-after study plus qualitative interviews

Methods
Twenty lay-people from across Scotland agreed to take part and to receive the intervention (35 text-messages over approx. 6 weeks) At baseline and after participants had received intervention (approx. 6 weeks later) we measured how likely people were to perform CPR (intention) in relation to 4 scenarios and self-assessed competence and confidence about performing CPR (self-efficacy) in general. We conducted qualitative interviews with 10 participants to elicit their views of the intervention

Results
Twenty lay-people (6F, 14M; aged 20-84) participated, all providing full baseline data. 19/20 participants received at least 20 messages. 15/20 provided follow-up data and ten were interviewed. Baseline intentions to initiate CPR in CPR scenarios were high (18.1) but still greater after the intervention (19.5). Increases in theory-based predictors of intention, self-efficacy (pre:74.5 post:81.0) and self-assessed competence (pre:19.5 post:20.5) were also observed following the intervention. Qualitative data suggested the intervention was positively received and viewed as helpful in improving confidence by reinforcing and building on messages from training. Interviewees suggested additional options for delivery format and pace would be helpful.

Conclusions
A behaviour-change text-message intervention delivered after CPR training is acceptable, easily scalable and may help improve rates of lay CPR initiation. Full scale evaluation of effectiveness is planned.
Association of age on the time of primary pci activation for stemi patients at emergency department
Authors: Berga Congost G , Martinez Momblan M A M M , Valverde Bernal J V B , Marquez Lopez A M L , Ruiz Gabalda J R G , Garcia Picart J G P , Puig Campmany M P C , Brugaletta S B 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Strategic Health Research and Innovation Plan (PERIS) 2016-2020

Background
Time between arrival at the Emergency Department (ED) and STEMI activation is a good indicator of the ED quality. Times of attention are of particular importance in some STEMI subgroups, such as elderly. Elderly patients are underdiagnosed and inadequately treated, resulting in a worse prognosis and survival rate.

Aim
To determine association of age with the activation time in STEMI patients admitted to ED.

Methods
An observational retrospective study was conducted including all patients admitted to the ED activated as a STEMI between 2013 and 2016. The main variable was the activation time, defined as the time between ED arrival and primary PCI activation.

Results
A total of 330 patients were included. They were classified by age: 51.1% (167) &lt;65 years old and 48.9% (160) ≥65 yo. Elderly patients exhibited more atypical symptoms and ECG changes as compared to younger. Being elderly (p=0.003) and having had medical contact prior to going to the ED (p=0.015) were associated with a longer activation time. Women older than 65 years old showed the longest activation time.

Conclusion
STEMI delays are longer in elderly with atypical presentation. Age ≥65 and first medical contact outside the ED were associated with an increase in the activation time. This highlights the need to develop strategies to improve STEMI activation time for elderly.
Relationship between multimorbidity and prevalence of frailty syndrome in patients qualified for elective cardiac surgery.
Authors: Wleklik M , Kaluzna-Oleksy M , Czapla M , Uchmanowicz I 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Intorduction
Frailty syndrome (FS) and multimorbidity are closely related but separate constructs that are associated with higher risk of death, higher rehospitalization rates, disability, and reduced quality of life. Identification of multimorbidity and FS in the cardiac surgery patient population appears to be important in terms of the qualification process, incidence of perioperative risk, and optimization of patient status before the cardiac surgery procedure.

Purpose
Analysis of the relationship between multimorbidity and FS in patients qualified for elective cardiac surgery.

Methods
The study included 100 patients ≥ 65 years of age (40 women and 60 men, mean age M±SD =71.69±4). The study included elderly patients qualified for elective cardiac surgery (coronary artery bypass grafting, valvular surgery or combined surgery). In the study group frailty was identified with the use of standardized research tools including those for one-dimensional and multidimensional assessment (FRAIL scale, Frailty Phenotype, 5-meter gaid speed, Tilburg Frailty Indicator, Tilburg Frailty Indicator - TFI). The presence of more than 3 chronic diseases was considered as multimorbidity. A significance level of 0.05 was assumed in the analysis, so all p&lt;0.05 values were interpreted as indicating significant relationships.

Results
Multimorbidity was reported in 88% of patients qualified for cardiac surgery. The prevalence of FS varied according to the screening tool used.Based on FRAIL was reported in 27% of patients, based on Frailty Phenotype in 17% of patients, based on 5-meter gaid speed in 43% of patients, and based on TFI in 63% of patients. In patients with multimorbidity FS was significantly more frequent than in patients without frailty syndrome, which was confirmed by FRAIL (96.3% vs. 60.0%; p-=0.003) and TFI questionnaire (95.2% vs. 75.7%; p=0.008) scores.

Conclusions
1. Most elderly patients qualified for elective cardiac surgery procedures are characterized by multimorbidity. 2 Multimorbidity is associated with a higher prevalence of FS in both unidimensional and multidimensional assessment. 3 This phenomenon requires further study, especially with regard to the occurrence of outcomes in this patient population.
Seasonal differences in nutritional status of patients hospitalized with heart failure with reduced ejection fraction.
Authors: Szubarga A , Sawczak F , Soloch A , Cierzniak M , Kukfisz A , Szczechla M , Migaj J , Dudek M , Straburzynska-Migaj E , Krysztofiak H , Przytarska K , Kaluzna-Oleksy M 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/Introduction
Heart failure (HF) is increasing steadily while the prognosis still stays poor despite improvements in care and availability of new therapies. The nutritional status. is important in management of HF, as an part of multidisciplinary approach. It is known that the diet depends on the availability of nutritional products and therefore also on the season. The seasonal differences of the nutritional status in HF to our knowledge has not been studied before.

Purpose
The assessment of variability in nutritional status among patients with heart failure with reduced ejection fraction (HFrEF) in different seasons of the year.

Methods
We enrolled 240 consecutive patients hospitalized at the department of cardiology, due to HFrEF with left ventricular ejection fraction (LVEF) &lt;=40%. Patients were interviewed with MNA form to assess their nutritional status. Detailed medical history was collected. Patients were divided according to the astronomical season of the year (spring summer fall winter), depending on the time of the admission to the hospital. We compared MNA scores between mentioned groups of patients using U Mann Whitney test. Due to the possible influence of HF exacerbations on nutritional status, the second analysis was done after exclusion of patients with HF decompensation.

Results
Mean age was 56.4±11.3 years, 15.8 % patients were women, mean BMI – 28.8±5.5 kg/m2, mean LVEF – 23.9±7.7%, mean MNA score – 23.0±2.9 points. MNA score was higher (the sign of better nutritional status) in patients interviewed during spring compared to those assessed in summer (p=0.0094) or fall (p=0.014). The same situation was observed after the exclusion of patients with decompensation of HF: MNA score measured in patients admitted in spring was better than those hospitalized in summer (p=0.042) or fall (p=0.0064). The difference between spring and winter lacked statistical significance (p=0.058). Mean MNA scores and more important data for every season are presented in Figure 1 and 2.

Conclusion(s)
The differences in nutrition state in stable patients with HFrEF suggest that the seasonality of the diet might result from veritable modification in nutrition associated with availability and price of fruit and vegetables or the respondents mood, unrelated to the real nutritional status, impacts the score in the MNA questionnaire. This requires further analyses.
Cardiac profile and risk factors of patients with coronary artery disease undergoing cardiac rehabilitation
Authors: Munoz Gomez E , Mont J , Sentandreu-Mano T , Sempere-Rubio N , Orihuela L , Moreno-Segura N , Berga-Congost G , Marques-Sule E 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Cardiovascular risk factors (CVRF) may contribute to the development and adverse outcome of coronary artery disease (CAD), thus the screening for CVRF in CAD patients undergoing cardiac rehabilitation is relevant.

Purpose
This study aimed assessing the cardiovascular risk factors in patients with CAD undergoing cardiac rehabilitation.

Methods
A cross-sectional study was performed. 201 patients with CAD undergoing cardiac rehabilitation were recruited. Anthropometric measurements and analytical tests were performed for each patient. Several variables related to cardiovascular risk factors were identified: weight, body mass index, abdominal circumference, blood pressure, smoking status, sedentary lifestyle, family history, basal level of glycosylated hemoglobin, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides.

Results
82,5% of patients were men, mean age 58,24 ± 9,40 years. 46,2% had effort angina pectoris, 32,4% had infarction and 21,4% had unstable angina pectoris. Most of the sample had a moderate risk (51,5%), whereas 33,8% had low risk and 14,7% had high risk. 63,9% underwent percutaneous coronary intervention with stent, and 27% underwent coronary artery bypass grafting. The most prevalent risk factors were overweight (77,05%), dyslipidemia (64,3%), hypertension (58,10%), sedentary lifestyle (50%), family history (44,90%), smoking (22%) and diabetes mellitus (20,40%).

Conclusions
The prevalence of cardiovascular risk factors among patients with coronary artery disease undergoing cardiac rehabilitation is high. 51,5% had a moderate risk, whereas overweight and dyslipidemia are leading risk factors.
Antidepressant medication and risk of cardiovascular disease in posttraumatic stress disorder patients: application of marginal structural models in Korean National Health Insurance Database
Authors: Kim K , Kang S , Jung S J 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): - National Research Foundation of Korea (NRF) grant funded by the Ministry of Science and ICT

Introduction
Previous evidence on antidepressant medication and cardiovascular disease (CVD) in posttraumatic stress disorder (PTSD) patients is mixed. We evaluated associations between antidepressant medication and CVD by applying marginal structural model.

Methods
We gathered medical utilization records of 27,170 patients diagnosed with PTSD in years 2004 - 2018 without prior CVD diagnosis from Korean National Health Insurance Database (NHID). PTSD and CVD were characterized in correspondence of ICD-10 diagnostic codes. We acquired information on antidepressant use from medical utilization records and categorized by medication category: selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs). Discrete-time survival analysis with marginal structural inverse probability weighting was used to test association between antidepressants and CVDs and were compared to results from traditional time-fixed model and simple time-varying model. We calculated cumulative daily defined doses (DDDs) of each antidepressant categories and conducted polynomial splining to test dose response.

Results
SSRI use was associated with acute coronary syndrome (hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.26 - 1.86) and ischemic stroke (HR 1.33, 95% CI 1.08 - 1.63). SNRI use was associated with acute coronary syndrome (HR 1.52, 95% CI 1.09 - 2.12). TCA use was associated with acute coronary syndrome (HR 1.54, 1.21 - 1.96) and ischemic stroke (HR 1.34, 1.06 - 1.70). Polynomial spline showed positive dose-response in association between antidepressant use and CVD.

Conclusion
Antidepressant use is causally associated with CVD in patients with PTSD. Higher cumulative DDD of antidepressant increases the risk of CVD.
Spontaneous coronary artery dissection; a systematic review of physical and psychosocial recovery following discharge from hospital
Authors: Neubeck L , Mchale S , Ross M , Galbraith M , Hanson C 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Edinburgh Napier University

Introduction
Spontaneous coronary artery dissection (SCAD) is increasingly recognised as an important cause of myocardial infarction, particularly among women. SCAD survivors may not know what physical activity is safe and effective and there may be a psychosocial burden of living with a SCAD diagnosis. This review aimed to determine the evidence regarding physical activity, cardiovascular risk factors, or associated factors, and the psychosocial impact of SCAD for SCAD survivors after hospital discharge.

Methods
A systematic review completed in accordance with PRISMA guidelines

Results
The review included 28 studies. These used a range of methods. None were randomised controlled trials. There were 4167 SCAD participants although some were sourced from the same SCAD registries, so may not be unique. They were mainly female (n=3897 93.5%, range=57.7%-100%), with mean age 48.0±9.8 years at index event. Participants mostly came from the USA, Canada, or the Netherlands. We found very limited evidence for cardiorespiratory fitness improvements following cardiac rehabilitation (CR). Existing CR was not tailored to SCAD specific needs and SCAD survivors lacked guidance about appropriate physical activity. Some participants had high levels of psychosocial distress. SCAD survivors highlighted the need for tailored support that included family members. Many SCAD survivors have traditional risk factors including hypertension, hyperlipidaemia and overweight/obesity. Chest pain following SCAD is common.

Conclusions
There is an urgent need to develop physical and psychological recovery programmes for SCAD survivors, and test effectiveness via randomised controlled trials. Psychosocial support is particularly required, given the high burden of psychosocial issues.
Mortality, morbidity, and cardiovascular risk factor outcomes from cardiac rehabilitation, in ethnic minorities: a systematic review and meta-analysis
Authors: Duggan S , Candelaria D , Zhang L , Ghisi G , Gallagher R 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Abstract

Background
Cardiac rehabilitation (CR) is a secondary prevention intervention for coronary heart disease that has well-established efficacy in reducing mortality, morbidity, and cardiovascular risk factors. However, outcomes from CR are known to differ between population groups, with ethnic minorities reported to have health outcome disparities. However, there is no synthesis of these CR outcomes for ethnic minority populations.

Purpose
The main purpose of this study was to evaluate the impact of CR on rates of mortality, morbidity, and important cardiovascular risk factor outcomes including exercise performance, exercise capacity, low-density lipoproteins, cholesterol levels, body mass index, weight, waist circumference and systolic blood pressure, within ethnic minority groups.

Methods
Four electronic databases (Medline, EMBASE, CINAHL, Scopus) were searched from February to September 2021, for studies that reported CR outcomes of ethnic minorities. Potential papers were independently screened by two reviewers, and discrepancies were resolved by a third reviewer. Data was extracted from the studies using an electronic data extraction form. Meta-analyses for eligible studies were performed using Revman 5.4. Risk of bias were assessed using the Cochrane Tool.

Results
Across 13 studies (n = 132,109 participants), the 10,494 participants of ethnic minority groups achieved significant improvements in mortality, morbidity, and most cardiovascular risk factor outcomes including exercise performance, exercise capacity, body mass index, waist circumference, and systolic blood pressure. However, while ethnic minority groups achieved equivalent outcomes from CR for exercise performance and low-density lipoproteins, some outcomes were worse (exercise capacity, body mass index, waist circumference, systolic blood pressure). In addition, minority participants had greater reductions in cholesterol levels.

Conclusion
Ethnic minority groups achieve important improvements in mortality, morbidity, and cardiovascular risk factor outcomes from CR, although to a lesser extent than majority groups. Therefore, this information can be used to support efforts to improve participation in CR and prompt changes to the delivery of CR services for ethnic minority participants.
Interests and preferences towards technology-based cardiac rehabilitation in men and women with coronary artery disease
Authors: Munoz Gomez E , Orihuela L , Deka P , Klompstra L , Pathak D , Sempere-Rubio N , Sentandreu-Mano T , Mont J , Moreno-Segura N , Cruz M , Westas M , Marques-Sule E 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Several studies have demonstrated the effectiveness of telemedicine programmes in patients with coronary artery disease (CAD). However, the development of these programmes is driven from a technical point of view and does not usually take into account the needs and expectations of patients. Thus, we found a need to study the interests and preferences towards technology-based cardiac rehabilitation (CR) in patients with CAD.

Purpose
The aim of this study was to compare the interests and preferences towards technology-based CR in men and women with CAD.

Method
A cross-sectional study was conducted. A total of 70 subjects with CAD (84.28% male) were included. Participants' interests and preferences were measured using the Technology Usage Questionnaire, which includes items on digital health and technology usage.

Results
On the one hand, men showed a greater interest in receiving CR counselling via mobile phone (p=0.022), would sign up for a free technology-based CR programme (p=0.034) and would like to receive less than 1-2 messages a week (p=0.010). On the other hand, women showed greater interest in receiving information about the different components included in the CR programme (receiving healthy meal/recipe ideas (p=0.002), reminders to take medication (p=0.039) and showed greater interest in meeting other people with heart disease (p=0.034). No differences were found by gender in type of communication that participants would like to receive through their mobile phone (p=0.154) or through the Internet (p=0.648), interest in receiving treatment through the Internet (p=0.454), interest in receiving an exercise-based CR program using virtual reality (p=0.810), nor usefulness of a virtual CR session (p=0.801).

Conclusions
In subjects with CAD, gender appears to be a determinant of interest. Men showed a greater interest in receiving CR counselling via mobile phone, would sign up for a technology-based CR programme and would like to receive fewer notifications. Women were more interested in receiving information about different components of the CR programme.