bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of gender on the time of first medical contact 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 , Marques Sule E M S , 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 first medical contact (FMC) and STEMI activation is a good indicator of the Code STEMI quality. Times of attention are of particular importance in some STEMI subgroups, such as women. Women receive later, inadequate treatment and their mortality rate is higher.

Aim
To determine association of gender with the FMC- 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. Patients identified as STEMI on a pre-hospital basis, in other hospitals or in primary care centres and activated as code STEMI before being admitted to the hospital were excluded. The main variable was the FMC- activation time, defined as the time between FMC and primary PCI activation. Main clinical variables and comorbidities, in-hospital mortality, hospital stay (in days), and false STEMI positives were also recorded.

Results
A total of 330 patients were included. They were classified by gender: 23.9% (78) women and 76.1% (249) men. Women exhibited more atypical symptoms and ECG changes as compared to men, with abdominal pain (p=0.029), scapular pain (p=0.003), rib pain (p=0.035), back pain (p=0.013) and general poor condition (p=0.008). Delays in the STEMI response time are longer in the case of women, particularly in the following intervals: FMC-activation (p=0.049) and arrival at the Haemodynamic-balloon (p= 0.021).

Conclusion
FMC- activation time are longer in women with atypical presentation. The longest time was detected in women older than 65 years old. This highlights the need to develop strategies to improve STEMI activation time in women.
Implementation of nurse-led early mobilisation after transcatheter aortic valve implantation: Identification of barriers to standardised practice
Authors: Lauck S , Bancroft C , Yu M , Polderman J , Andrews H , Stephenson A 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
We examined the barriers of early nurse-led mobilisation after transcatheter aortic valve implantation (TAVI) to support safe next-day discharge home.

Methods
We conducted a prospective observational cohort study of patients treated in 2019-2021 using a standardised post-procedure nursing care standard to promote mobilisation in 4 to 6 hours after TAVI. Results are presented as mean (standard deviation) for continuous variables and as number (percentage) for categorical data; student t test was used to compare continuous variables and χ2 and Fisher exact tests were used to compare categorical variables. All analyses were performed in SAS version 9.4 (SAS Institute).

Results
The cohort included a convenience sample of 139 patients (64 women, 46%) mean age 82.5±6.7 years, NYHA III/IV 72 (51.8%), prior pacemaker 18 (13%), and prior SAVR 11 (7.9%). Patients were treated under local anaesthesia only (n=29, 20.9%) or conscious sedation (n=106, 76.3%) with a balloon expandable device (n=134, 96.4%) in a cardiac catheterisation laboratory (n=111, 79.9%) or hybrid operating room (n=28, 25.2%), and early recovery in cardiac telemetry (n=101, 72.7%) or critical care unit (n=38, 27.3%). Early mobilisation was achieved in 113 patients (81.3%: 4 hours: n=100, 71.9%, 4-6 hours: n=13, 9.4%); there were no significant (p≤0.05) differences in baseline characteristics between patients with early vs. late mobilisation; the primary reasons for delayed mobilisation included monitoring and/or managing cardiac conduction issues (n=6), vascular access hemostasis (n=6) and neurological status (n=4), patient preference or other self-reported issue (n=5) and nursing workload (n=5). In patients who achieved early mobilisation, 81.4% were discharge on post-operative day 1 and 86.3% by day 2, with 99.1% returning directly home. There was no significant difference in 30-day readmission between the two groups.

Conclusions
Early nurse-led protocol-driven mobilisation is safe and effective to facilitate rapid reconditioning and safe transition home after uncomplicated TAVI. Research is needed to better understand patient and systems-level enablers to improve standardisation of practice.
For hypertensive patients with comorbidity, the number of comorbidity is associated with the pattern of their medication adherence
Authors: Oh O , Lee K S 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Although medication adherence is an important self-care activity for hypertensive patients, their medication adherence is not often optimal. When patients with hypertension have comorbidities, they are asked to adhere to medications prescribed for all of their conditions, resulting in a greater burden. Some may decide to take medications for conditions they prioritize, while others may take all medications as prescribed. It is possible that the number of comorbidity affect the pattern of the patients’ medication adherence.

Purpose
To examine if the number of comorbidity is associated with the medication adherence pattern in patients with hypertension and at least one of the following comorbidity related to poor outcomes in hypertensive patients: diabetes, hyperlipidemia, ischemic heart disease and stroke.

Methods
A secondary data analysis was conducted using the 2018 Korea Health Panel Survey, including 2218 hypertensive patients with at least one of the following comorbidity: diabetes, hyperlipidemia, ischemic heart disease and stroke. Two types of medication adherence was assessed: primary (i.e., filling prescriptions of medications prescribed by clinicians) and secondary medication adherence (i.e., taking medications as directed). Patients were divided into three groups based on the patterns of primary and secondary medication adherence in each comorbidity (Figure 1). Multinomial logistic regression was used to determine whether the number of comorbidity was associated with the medication adherence pattern after controlling for relevant covariates (i.e. age, gender, marital status, income level, education level, unmet medical needs and presence of primary care providers).

Results
A total of 2218 patients (mean age 70.1, female 58.7%) had an average of 1.5 comorbidities (SD: 0.7); 10% had three or more comorbidities. About four-fifths of the patients (84.9%) were adherent to medications for all their chronic conditions (i.e., adherent group), 11% partially adhered to their medications (i.e., suboptimal group) and 4.1% did not adhere to any medications (i.e., non-adherent group). Compared with the adherent group, the suboptimal group were more likely to have a greater number of comorbidities after adjusting for covariates (adjusted odds ratio [aOR]=1.46). On the other hand, compared with the adherent group, the non-adherent group were more likely to have a smaller number of comorbidities (aOR=0.54).

Conclusion
Our study showed that an increased number of comorbidity is a risk factor for inconsistent medication adherence. However, since we also found that patients with a smaller number of chronic conditions were likely to be non-adherent to all medications, hypothesizing that increased number of comorbidity is associated with medication non-adherence may have been simplistic regarding these patients. The unexpected findings of non-adherent group needs to be further explored.
Soluble ST2 and nutritional status in patients hospitalized with heart failure with reduced ejection fraction - pilot study
Authors: Wasniewski F , Sawczak F , Kukfisz A , Szczechla M , Krysztofiak H , Przytarska K , Kaluzna-Oleksy M , Dudek M , Migaj J , Straburzynska-Migaj E 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Student Scientific Society

Background
Chronic heart failure with reduced ejection fraction (HFrEF) is very often accompanied by malnutrition, which seems to be a marker for poor prognosis. With still high prevalence of HFrEF new aspects of malnourishment should be assessed in order to plan a more individualized management and to achieve better prognosis. In addition to that the multimarker approach to evaluating HFrEF is gaining importance. One of the most promising new markers seems to be the soluble receptor for interleukin-33 (IL-33) - sST2 peptide.

Purpose
The aim of the study was to find relationship between serum sST2 level and malnourishment indicators in patients with HFrEF.

Methods
33 consecutive patients hospitalized in the Department of Cardiology. The sST2 level was assessed using the rapid ST2 test. We assessed nutritional status with the Mini Nutritional Assessment (MNA) questionnaire and collected the chosen clinical and biochemical parameters related to nutrition. It was tested if sST2 level could predict risk of malnutrition defined as MNA score below or equal to 23.5 using ROC curve analysis. Then to further evaluate the relation between nutritional status and sST2 level appropriate correlations were tested.

Results
The studied group consisted of 9.1% women, mean age was 55.3 ± 10.0 years, left ventricular ejection fraction - 24.8 ± 8.7%, sST2 level - 49.84 ± 37.02 ng/ml. Using ROC curve analysis we found that sST2 levels can predict the risk of malnutrition with both considerable sensitivity – 0.786, specificity – 0.737 and an area under the curve (AUC) 0.726 (95%CI 0.548-0.903; p=0.013). The optimal cutoff point - 35 ng/ml was derived and according to this value patients were divided into two groups. MNA score was 22.4 ± 2.3 in group with high ST2 (&gt;35 ng/ml) and 24.4 ± 2.4 in group with low ST2 (&lt;35 ng/ml); the difference was statistically significant (p=0.026). Using Spearman’s Rank-Order Correlation we found that sST2 level correlated significantly with total protein level (p=0.0349, R=-0.46), albumin level (p&lt;0.001, R=-0.80) and total cholesterol level (p=0.002, R=-0.52), while no relevant relation to BMI nor triglycerides was found.

Conclusions
The study revealed a potential value of sST2 level in predicting impaired nutritional status defined with MNA and its correlation with serum protein, albumin and total cholesterol. More research needs to be conducted in order to verify these relations and to study its usefulness.
ManGuard an eHealth intervention to reduce cardiovascular risk in male taxi drivers: a pilot randomised controlled trial protocol
Authors: Ski C F , Mcmahon J , Mcmahon J , Brazil K , Brazil K , Thompson D R , Thompson D R 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Department for the Economy, Northern Ireland

Background
Men are at higher risk then women of developing cardiovascular disease (CVD) and male taxi drivers are a particularly high risk group because of their typically unhealthy behaviours, such as poor eating habits, smoking and a sedentary lifestyle. However, only two studies of behavioural interventions targeting taxi drivers have been identified, one of which had a high attrition rate. Therefore, an eHealth intervention co-designed by taxi drivers may prove more user-friendly and effective.

Purpose
The aim of this study is to assess the feasibility of a randomised controlled trial (RCT) of an eHealth intervention – ManGuard – to reduce CVD risk in male taxi drivers.

Methods
A wait-list controlled trial of 30 male taxi drivers in Belfast, Northern Ireland, will be assigned randomly to an intervention or usual care group. The ManGuard Application comprises seven modules: i) introduction and goal setting, ii) being active iii) eating well, iv) managing stress, v) smoking, vi) alcohol and vii) keep accelerating, the latter to be used as a re-cap module. This trial will establish feasibility, including recruitment, engagement and retention rates, program usability and participant satisfaction, as well as preliminary efficacy of ManGuard in improving key outcomes. Primary outcome is to determine the feasibility of an eHealth intervention for reducing CVD risk in male taxi drivers by assessing the following outcome measures:
o Acceptability, recruitment, retention and engagement rates
o Usability and participant satisfaction, process evaluation and survey
The secondary outcome is to evaluate the preliminary efficacy of ManGuard compared to usual care in improving the following outcomes:
o Clinical indices: CVD biomarkers (cholesterol, glucose), blood pressure, anthropometry (BMI, waist circumference, body fat percentage)
o Physical activity
o Psychosocial status: health related quality of life, self-efficacy, social support
An in-depth qualitative process evaluation to explore acceptability of the intervention will also be conducted.
Trial registration: This trial has been registered prospectively on the ISRCTN registry on 5 January 2022

Conclusion
eHealth interventions have been shown to promote behaviour change and reduce CVD risk in men, but there is a lack of robust evidence for this in male taxi drivers, a high-risk group. This study aims to assess the feasibility of a future RCT assessing the impact of ManGuard on CVD risk in male taxi drivers. This study will inform a fully-powered trial that will provide robust evidence for eHealth interventions for this underserved population.
Cardiovascular risk factors in a healthy population in the Croatian centre for cardiac rehabilitation
Authors: Brajkovic I , Komosar-Cvetkovic M , Kuzet Miokovic I 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
According to the statistics of the WHO, cardiovascular diseases (CVD) are the leading cause of death. The problem of CVD is the fact that they do not give the right symptoms, and often lead to personal or public health problems. The first signs of CVD may be an acute myocardial infarction (AMI) or cerebrovascular insult (CVI) and it is important that the cause of them is a combination of risk factors (RF) that we can influence. High cardiovascular risk, due to the presence of one or more RF, requires early intervention with the aim of timely prevention of possible new complications.

Purpose
The aim of the retrospective study was to determine the prevalence of cardiovascular RF in persons who underwent preventive examinations at our Clinic for Treatment, Prevention and Rehabilitation of CVD.

Methods
The study included 100 respondents aged between 30 and 60y. When collecting and presenting data, the privacy and identity of the respondents are protected. For the purposes of the research, the data of medical documentation were used. The parameters used for the study were age, sex, height, weight, body mass index, abdominal thickness, arterial pressure values, blood sugar, ergometric and spirometry findings. For each respondent, daily life habits such as alcohol and smoking consumption, and levels of physical activity were recorded. Microsoft Excel and Statistics are used for data processing.

Results
According to the analysis of the obtained data, an equal number of men and women participated in the research (average age 47y). Anthropometric testing yielded a mean BMI for men and women which tells us that 44% of respondents are overweight and 21% are obese. Prior to the examination, 20% of respondents were diagnosed with arterial hypertension (AH), arrhythmia, hyperlipoproteinemia and diabetes. Only 2% of the subjects had elevated blood glucose values. Spirometric findings in all subjects were correct, while ergometric testing showed a decrease in values in as many as 75% of subjects. The control of daily living habits determined the enjoyment of tobacco products in 32% and alcohol in 10% of respondents. A worrying fact is that only 5% of respondents engage in some physical activity. In addition, new diagnoses are hyperlipoproteinemia IIa (40%), hyperlipoproteinemia IIb (16%), AH (13%), hyperlipidemia (6%), arrhythmia (4%), diabetes (2%), triglyceridemia (2%), ischemic heart disease (1%), carotid artery stenosis (1%).

Conclusions
The study found an increased incidence of cardiovascular RF in people who are not older. New diagnoses suggest a change in life habits towards eliminating the present cardiovascular RF in order to prevent possible cardiovascular incidents. It is through this organized, systematic and regular prevention that cardiovascular diseases are reduced to a significant level.
Using co-design to create user-friendly material promoting cardiac rehabilitation
Authors: Caughers G , Wilson A , Donnelly P , Bradley J , Fitzsimons D 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Public Health Agency Northern Ireland, Research and Development PhD Fellowship

Background
Cardiac Rehabilitation (CR) participation rates remain stagnant across Europe at around 40%(1) , with similar low uptake in Northern Ireland. Patients in our Steering Group confirmed that misconceptions about CR and lack of clear explanations negatively influence their decision to attend. Patients can feel overwhelmed by the experience of a cardiac event and the importance of CR is easily overlooked. Co-production of a short information film could better inform patients, family and the public.

Methods
Focus groups and interviews with N=58. Patients and carers informed 2 co-design workshops identifying the need for an information film to be available to cardiac patients and their families. Between July and November 2021, virtual multidisciplinary staff and patient groups developed the film with all members contributing to the script, voice content and film footage. A professional film company produced the 90 second infomercial with direction from patients and CR professionals.

Results
The information film portrays the experiences of a male and female patient. Elements of CR that were perceived as attractive components by patients in the codesign workshops are portrayed including; one to one interactions between staff and patients, the diversity of CR teams, and comradery between patients. The film is designed to be viewed on multiple devices, in hospital and at home following discharge.

Conclusion
Providing information about CR through the media of film may help to dispel misconceptions of CR and promote its attractiveness to patients. The effectiveness of this film awaits evaluation following dissemination to staff and patients this year.
Let’s get active: patients with a recent coronary event are highly motivated to lose weight and increase physical activity levels
Authors: Van Trier T , Jorstad H T , Peters R J G , Somsen G A , Sunamura M , Ter Hoeve N , Scholte Op Reimer W J M , Snaterse M 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NWO-grant
Title (Dutch): Het centraal stellen van behandelvoorkeuren van de individuele patiënt met een chronische hartziekte.
Subtitle: Persoonsgerichte zorg voor hartpatiënten

Introduction
Motivated patients are more likely to successfully improve unhealthy lifestyles. How patients perceive their risk factors and their willingness to improve is an integral part of this motivation. However, such preferences, and how they align with clinicians’ risk perception are seldom systematically assessed in patients with coronary artery disease (CAD).

Purpose
We aimed to investigate preferences in risk factor treatment in patients with CAD, and to compare this with clinicians’ perception of patients’ risks.

Methods
We administered a 10-item questionnaire on patients’ preferences on risk factor treatment in secondary prevention which was developed in consultation with end-users. We sent the questionnaire to approximately 450 patients who were referred to cardiac rehabilitation after recent (&lt;3 months) admission to an acute coronary unit between Feb 2020 and Apr 2021. We demonstrate the results of 6 questions that covered the following subjects relevant to secondary prevention: Q1: risk factor perception, Q2: priority setting, Q3: wanting help, Q4: willingness to change, Q5: motivation to change, Q6: confidence to successfully change. We compared patients risk factor perception with clinicians’ report in the medical record.

Results
A total of 296 patients completed the survey (66% of eligible respondents) at mean (SD) age 64 (10) years on median (IQR) 38 (25-53) days after discharge. Physical activity was much more frequently reported as risk factor by patients (P 55%) compared to clinicians (C 31%), followed by other disparities such as for high cholesterol (P 48% vs. C 36%) and overweight (P 46% vs. C 59%) (Figure 1). Patients were asked which of their perceived risk factors on Q1 was most important to improve (Q2) and for which they wanted help (Q3). Top-3 risk factors chosen for improvement were overweight (87%), physical inactivity (81%), and stress (79%), for which 75% required help with any risk factor, again most frequently with increasing physical activity (64%), overweight (59%) and stress (51%) (Figure 2). Motivation and confidence for improvement of risk factors were high: 87% were willing to adapt their lifestyles, with motivation rates of median (IQR) 8 (7-9) out of 10, and estimated chance for successful improvement of median (IQR) 7 (6-8) out of 10.

Conclusion(s)
Patients who recently suffered from coronary event are highly motivated to lose weight and increase physical inactivity. The use of these patient preferences by the clinician will enable compliance and outcomes with respect to weight loss and improved physical activity.