Abstract:
BACKGROUND:Acute heart failure (HF) is a frequently encountered cardiac condition. Its prevalence increases exponentially with age. In spite of this, elderly patients are underrepresented in clinical trials and the implementation of guideline-based medical therapy (GBMT) in them is not well established. We investigated the current use of GBMT and its effects on mortality and HF rehospitalization among elderly patients with acute HF with reduced ejection fraction (HFrEF) using data obtained from a contemporary multi-center registry. METHODS AND RESULTS:We analyzed data from 1,441 consecutive acute HF patients registered in the West Tokyo Heart Failure (WET-HF) registry (mean age 73.2 ± 13.6 years). Reduced ejection fraction (<45%) was noted in 803 patients (55.7%), of which 237 were aged ≥80 years (elderly group). The prescription rate of GBMT (use of renin-angiotensin system inhibitors and β-blockers at discharge) was significantly lower in the elderly than in the younger (aged < 80 years) group (46.8% vs. 66.9%, p<0.001). Although GBMT at discharge was associated with reductions in HF readmission or the composite endpoint of cardiac death and HF readmission (HR 0.49, 95% CI 0.30-0.80; and HR 0.53, 95% CI 0.32-0.89, respectively) in the younger group, this association was not observed in the elderly group (HR 1.41, 95% CI 0.68-2.92; and HR 1.54, 95% CI 0.76-3.13, respectively) CONCLUSIONS: GBMT implementation in elderly patients with HFrEF was found to be suboptimal. However, the underuse of GBMT did not appear to be responsible for poorer outcomes in elderly HFrEF patients. Further research is required to establish an ideal therapeutic approach for this population. CLINICAL TRIAL REGISTRATION:URL: http://www.umin.ac.jp/icdr/index-j.html. Unique identifier: UMIN000001171.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Akita K,Kohno T,Kohsaka S,Shiraishi Y,Nagatomo Y,Izumi Y,Goda A,Mizuno A,Sawano M,Inohara T,Fukuda K,Yoshikawa T,West Tokyo Heart Failure Registry Investigators.doi
10.1016/j.ijcard.2017.02.070subject
Has Abstractpub_date
2017-05-15 00:00:00pages
162-168eissn
0167-5273issn
1874-1754pii
S0167-5273(17)31098-7journal_volume
235pub_type
杂志文章abstract::The hearts of human embryos, ranging from 3.6 to 25 mM crown-rump length, have been studied in view of the problem of the possible contribution of the atrioventricular endocardial cushions to septation. Serial sections and graphic reconstructions were used. It is concluded that the cushions do not materially contribut...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(85)90261-x
更新日期:1985-05-01 00:00:00
abstract::The failure to translate novel cardioprotective therapies tested in pre-clinical studies into the clinical setting for patient benefit can be attributed to a number of factors at different stages of the research process. This review focuses on the evidences and the gaps with regard to the translational journey of card...
journal_title:International journal of cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.ijcard.2016.06.131
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:In 1960, all male inhabitants of a series of villages in rural Crete, born between 1900 and 1919, were invited to participate in the Seven Countries Study. Analysis of 25-year mortality data from the 16 cohorts of participants indicated that the cohort from Crete had the lowest age-standardised all-cause and...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2004.08.052
更新日期:2005-04-08 00:00:00
abstract:BACKGROUND:Effects of potassium supplementation on vascular function remain conflicting. This meta-analysis aimed to summarized current literature to fill the gaps in knowledge. METHODS:A literature search was performed on PubMed database through April, 2016. The measurements of vascular function included pulse wave v...
journal_title:International journal of cardiology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ijcard.2016.10.119
更新日期:2017-02-01 00:00:00
abstract:AIMS:Prospective data on the usage of 3-dimensional imaging based annulus sizing on the outcome of TAVI is not available yet and there is general uncertainty about the optimal degree of oversizing. In the current study we therefore assessed a 3-D MSCT guided over-sizing approach and evaluated the clinical outcome of di...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2013.03.030
更新日期:2013-10-03 00:00:00
abstract:OBJECTIVE:Transcatheter aortic valve implantation (TAVI) has been designed to treat elderly patients with severe aortic stenosis at high risk for surgery. These patients are also often affected by severe iliac-femoral arteriopathy, rendering the trans-femoral approach unusable. We report our experience with the direct-...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2014.11.108
更新日期:2015-02-15 00:00:00
abstract::Patient referrals from general practice for suspected heart failure are increasing the demand for echocardiograms, many of which are normal. We investigated whether general practitioners could be more selective by referring only patients with abnormal electrocardiograms for echocardiography. The electrocardiograms of ...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/s0167-5273(97)00181-2
更新日期:1997-10-31 00:00:00
abstract::Elderly patients represent an important proportion of the acute coronary syndrome (ACS) population. Furthermore, this group of ACS patients is continuously growing because of the progressive ageing of the population. The ageing process implies marked changes in patient physiology that directly impact in their risk. Ho...
journal_title:International journal of cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.ijcard.2016.07.205
更新日期:2016-11-01 00:00:00
abstract::We used silicone rubber as a material for making post-mortem casts of cavities in 21 human hearts, 16 of them congenitally malformed, 13 after surgical reconstruction (Fontan and Norwood procedures) and 4 after reconstruction had been performed posts mortem for study purposes. The organs were either fresh, or had been...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(89)90141-1
更新日期:1989-01-01 00:00:00
abstract::MicroRNAs (miRNAs) are short strands of approximately 21-25 nucleotides. MiRNAs are emerging as important biomarker candidates for various cardiovascular diseases. These small molecules are being currently investigated for diagnosis, prognosis and more importantly as therapeutic targets. This review tries to explore t...
journal_title:International journal of cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.ijcard.2014.06.027
更新日期:2014-08-20 00:00:00
abstract:BACKGROUND:Beraprost sodium, an orally active prostacyclin analogue, has proved to be beneficial for the patients with primary pulmonary hypertension and obstructive peripheral arterial disease. METHODS:In this study, we examined the effects of BPS on the expression of the VEGF and PAI-1 genes in vascular smooth muscl...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2007.12.119
更新日期:2009-03-06 00:00:00
abstract:OBJECTIVE:A number of observations suggest that cytokines may be important modulators in the ventricular remodeling process. It is unclear whether carvedilol modulates myocardial pro-inflammatory and anti-inflammatory cytokines expression. We hypothesized that carvedilol could improve ventricular remodeling partly thro...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2005.08.065
更新日期:2006-08-10 00:00:00
abstract:BACKGROUND:It is well known that cardiac rehabilitation (CR) including regular exercise training (ET) is cardioprotective with respect to clinical events in patients with acute myocardial infarction (AMI). However, it is not known whether the regular ET may affect coronary restenosis after percutaneous coronary interve...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2012.06.122
更新日期:2013-09-10 00:00:00
abstract::We have studied in a normal animal model (sheep), the biochemical and morphological adaptation of electrically stimulated skeletal muscle used for extra aortic counterpulsation. Immunocytochemical analysis of latissimus dorsi, using monoclonal antibodies to slow and fast myosin heavy chains, indicated an increase in t...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(91)90093-5
更新日期:1991-02-01 00:00:00
abstract::Carlos Chagas, the discoverer of Chagas' disease was nominated to the Nobel Prize in 1921, but none did win the prize in that year. As a leader of a young scientist team, he discovered all aspects of the new disease from 1909 to 1920. It is still obscure why he did not win the Nobel Prize in 1921. Chagas was discarded...
journal_title:International journal of cardiology
pub_type: 传,历史文章,杂志文章
doi:10.1016/j.ijcard.2013.08.137
更新日期:2013-11-20 00:00:00
abstract:BACKGROUND:Copeptin has turned out to give valuable prognostic information for future cardiovascular events. However, since its plasma concentration directly depends on renal function, the value of copeptin as a predictor for outcome also in patients with chronic kidney disease (CKD) is unknown. METHODS:In this single...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2016.07.058
更新日期:2016-10-15 00:00:00
abstract::Prostacyclin is a powerful inhibitor of platelet aggregation and induces relaxation of vascular smooth muscle. We have studied the coronary effects of high local concentrations of prostacyclin in 17 patients during the early stages of acute myocardial infarction. We infused graded concentrations of intracoronary prost...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(90)90247-3
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Left atrial appendage occlusion (LAAO) is an accepted strategy for cardioembolic events prevention in patients with non-valvular atrial fibrillation (AF) unsuitable for anticoagulation. However, uncertainties persist regarding the benefit of LAAO in highly-comorbid patients. The aim of this study was to asse...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2020.06.054
更新日期:2020-11-15 00:00:00
abstract::We describe a series of five patients who had cardiac tamponade at the time of initial presentation as a result of extracardiac malignancy. Three cases had adenocarcinoma and two had squamous cell carcinoma. The diagnosis of bronchogenic carcinoma was established after appropriate investigations in three cases. One pa...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(89)90063-6
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:Anemia is common in cardio-renal syndrome and may contribute to increase mortality. OBJECTIVE:To examine the prevalence of anemia and its relationship with cardio-renal syndrome, and to evaluate the risk factors for death. METHODS:Retrospective study with all patients admitted with congestive heart failure...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2006.10.005
更新日期:2007-08-21 00:00:00
abstract:BACKGROUND:The aim of this study was to investigate the prognostic value of myocardial focal fibrosis quantified by late gadolinium enhanced (LGE) magnetic resonance imaging (MRI) in patients with heart failure with preserved ejection fraction (HFpEF). METHODS:One-hundred eleven HFpEF patients (mean age: 70 ± 14 years...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2015.05.048
更新日期:2015-07-15 00:00:00
abstract:BACKGROUND:There is considerable research interest about the platelet GPIIb/IIIa receptor polymorphisms in CAD. METHODS:We investigated differences in the frequency of the polymorphism in the GPIIb subunit of the receptor HPA-3 (a and b allele) between patients with more extensive coronary thrombosis such as patients ...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2007.04.039
更新日期:2008-06-23 00:00:00
abstract:BACKGROUND:One of the most common nonsteroidal anti-inflammatory drugs (NSAIDs) used worldwide, diclofenac (DIC), has been linked to increased risk of cardiovascular disease (CVD). The molecular mechanism(s) by which DIC causes CVD is unknown. METHODS:Proteasome activities were studied in hearts, livers, and kidneys f...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2016.08.233
更新日期:2016-11-15 00:00:00
abstract::Thienopyridines and aspirin are beneficial in patients undergoing bare-metal stent implantation, and aspirin and clopidogrel treatment have also been proved effective after drug-eluting stent (DES) implantation. However, despite the common substitution of clopidogrel with ticlopidine because of cost or patient intoler...
journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2005.03.038
更新日期:2006-04-14 00:00:00
abstract::A rare case of fusiform aneurysm of the superior vena cava (SVC) in a 65-year-old Japanese woman is presented herein. Aneurysm of the SVC was detected incidentally as widening of the upper mediastinum on chest radiography and was further defined using magnetic resonance imaging, venography and chest computed tomograph...
journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2006.04.009
更新日期:2006-11-10 00:00:00
abstract::The ratio between maximal and minimal R-R intervals measured during the Valsalva maneuver is an adequate means of studying the functional state of the cardiac parasympathetic nervous system. We studied the changes in heart rate evoked during the Valsalva maneuver in 49 asymptomatic Chagasic patients with different deg...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(88)90053-8
更新日期:1988-03-01 00:00:00
abstract::We report a series of five cases of infective endocarditis caused by Streptococcus agalactiae (group B streptococcus) in Glasgow over a 30 month period. There were three males and two females mean age 48.6 years (range 28-63 years). Only one patient had previous valvular heart disease. The infections were characterise...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(89)90302-1
更新日期:1989-08-01 00:00:00
abstract:UNLABELLED:To determine the clinical value of several parameters derived by application of the proximal isovelocity surface area method in the assessment of mitral regurgitation (MR), 28 consecutive patients with angiographic diagnosis of MR underwent color Doppler echocardiography within 48 h of cardiac catheterizatio...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/s0167-5273(98)00355-6
更新日期:1999-02-28 00:00:00
abstract::Global systolic and diastolic LV function assessed by conventional echocardiographic indices is often normal in patients with controlled hypertension, with or without left ventricular hypertrophy. However, it is not certain whether regional myocardial function in these patients remains normal. We investigated 26 patie...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2005.10.001
更新日期:2006-10-10 00:00:00
abstract:BACKGROUND:Patients with acute coronary syndrome (ACS) associated to high C-reactive protein (CRP) levels exhibit a higher risk of future acute ischemic events. Yet, the positive predictive value of CRP is too low to guide a specific treatment. Our study aims to identify a high-risk patient subset who might mostly bene...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2019.01.058
更新日期:2019-07-01 00:00:00