Heart failure and comorbidities

Slides:

Advertisements

Similar presentations

Perioperative Management of Heart Failure Gamal Fouad S Zaki, MD Professor of Anesthesiology Ain Shams University

Advertisements

Natale MARRAZZO Francesco SOLIMENE Quando la CRT-P può bastare?

Temporal Trends in the Prevalence of Diabetic Kidney Disease in the United States Ian H. de Boer, MD, MS, Tessa C. Rue, MS, Yoshio N. Hall, MD, Patrick.

Valsartan Antihypertensive Long-Term Use Evaluation Results

Epidemiology of Peripheral Vascular Disease Sohail Ahmed School of Population and Health Sciences.

“Influence of age on the management of heart failure: Findings from Get With the Guidelines–Heart Failure (GWTG-HF)” Daniel E. Forman, MD; Christopher.

“ Age-Related Differences in Characteristics, Performance Measures, Treatment Trends, and Outcomes in Patients with Ischemic Stroke ” Gregg C. Fonarow,

Stanford Prevention Research Center STANFORD SCHOOL OF MEDICINE National Trends in the Prescribing of Anti-Hypertensive Medications Jun Ma, MD, PhD Research.

Efficacy and safety of angiotensin receptor blockers: a meta-analysis of randomized trials Elgendy IY et al. Am J Hypertens. 2014; doi:10,1093/ajh/hpu209.

analysis from the SHIFT study

Hospitalizations for Severe Sepsis Among Elderly Medicare Beneficiaries William Buczko, Ph.D. Research Analyst Centers for Medicare & Medicaid Services.

Surveillance of Heart Diseases and Stroke Using Centers for Medicare and Medicaid (CMS) Data: A Researcher’s Perspective Judith H. Lichtman, PhD MPH Associate.

Heart Failure Whistle Stop Talks No. 2 Classification Implications Susie Bowell BA Hons, RGN Heart Failure Specialist Nurse.

Hazard of incident coronary heart disease by diabetes status, with or without elevation of troponin T No diabetes Pre- diabetes Diabetes No diabetes Pre-

Approach to Advanced Kidney Disease Management in the Elderly Source: Schell JO, Germain MJ, Finkelstein FO, et al. An integrative approach to advanced.

Hemoglobin A 1c in Hemodialysis Patients Source: Ix JH. Hemoglobin A1c in hemodialysis patients: Should one size fit all? Clin J Am Soc Nephrol. 2010;5:1539–1541.

CHARM-Preserved: Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity - Preserved Purpose To determine whether the angiotensin.

Effects on outcomes of heart rate reduction by ivabradine in patients with congestive heart failure: is there an influence of beta-blocker dose? Systolic.

Chronic Obstructive Pulmonary Disease (COPD) is a major cause of chronic morbidity and mortality worldwide and in Singapore. In Singapore, there are about.

Effect of ivabradine on recurrent hospitalization for worsening heart failure: findings from SHIFT S ystolic H eart failure treatment with the I f inhibitor.

1 Objectives, design and initial results from Phase I Nils Schoof Corp. Dept. Global Epidemiology, Boehringer Ingelheim GmbH.

The burden Of heart failure

Influence of Comorbid Depression and Antidepressant Treatment on Mortality for Medicare Beneficiaries with Chronic Obstructive Pulmonary Disease by SSDI-eligibility.

S ystolic H eart failure treatment with the I f inhibitor ivabradine T rial Main results Swedberg K, et al. Lancet. 2010;376(9744):

S. HUNT Tenth International Symposium HEART FAILURE & Co. CARDIOLOGY SCIENCE UPDATE FEMALE DOCTORS SPEAKING ON FEMALE DISEASES Milano aprile 2010.

Red Cell Distribution Width (RDW) as a Novel Prognostic Marker in Heart Failure: Data from the CHARM Program and the Duke Databank.

M. JESSUP Tenth International Symposium HEART FAILURE & Co. CARDIOLOGY SCIENCE UPDATE FEMALE DOCTORS SPEAKING ON FEMALE DISEASES Milano aprile 2010.

RALES: Randomized Aldactone Evaluation Study Purpose To determine whether the aldosterone antagonist spironolactone reduces mortality in patients with.

The Renin-Angiotensin- Aldosterone System: Linking New Data and Mechanisms for Cardiovascular Risk Reduction VBWG.

The Studies of Oral Enoximone Therapy in Advanced Heart Failure ESSENTIALESSENTIAL Presented at The European Society of Cardiology Congress 2005 Presented.

Treatment and Risk in Heart Failure: Gaps in Evidence or Quality? Pamela N. Peterson, MD MSPH; John S. Rumsfeld, MD PhD; Li Liang PhD; Adrian F. Hernandez,

Higher Incidence of Venous Thromboembolism (VTE) in the Outpatient versus Inpatient Setting Among Patients with Cancer in the United States Khorana A et.

ALLHAT 6/5/ CARDIOVASCULAR DISEASE OUTCOMES IN HYPERTENSIVE PATIENTS STRATIFIED BY BASELINE GLOMERULAR FILTRATION RATE (3 GROUPS by GFR)

Heart rate in heart failure: Heart rate in heart failure: risk marker or risk factor? A subanalysis of the SHIFT trial on behalf of the Investigators M.

Advancing Our Understanding of RAAS Modulation in High-Risk Patients.

Relationship of background ACEI dose to benefits of candesartan in the CHARM-Added trial.

6/5/ CARDIOVASCULAR DISEASE OUTCOMES IN HYPERTENSIVE PATIENTS STRATIFIED BY BASELINE GLOMERULAR FILTRATION RATE (4 GROUPS by GFR) ALLHAT.

2007 Hypertension as a Public Health Risk January, 2007.

Rosuvastatin 10 mg n=2514 Placebo n= to 4 weeks Randomization 6weeks3 monthly Closing date 20 May 2007 Eligibility Optimal HF treatment instituted.

Short- and Long-Term Mortality After Myocardial Infarction in Patients With and Without Diabetes Featured Article: Sjoerd T. Nauta, M.S.C., Jaap W. Deckers,

Are the European Practice Guidelines for the Management of Arterial Hypertension (2007) adapted to the old and the frail? Anette Hylen

The SYMPHONY Trial Reference Reddan DN, et al. Renal function, concomitant medication use and outcomes following acute coronary syndromes. Nephrol Dial.

The CHART-2 Study (The Chronic Heart Failure Analysis and Registry in the Tohoku District 2) Source Shiba N, Nochioka K, Miura M, et al. Trend of westernization.

Original article Chronic Renal Failure A Neglected Comorbidity of COPD Raffaele Antonelli Incalzi, MD; Andrea Corsonello, MD; Claudio Pedone, MD; Salvatore.

Date of download: 6/26/2016 From: Variation in Outpatient Antibiotic Prescribing for Acute Respiratory Infections in the Veteran Population: A Cross-sectional.

The FAVORIT Study (Folic Acid for Vascular Outcome Reduction in Transplantation) Source Bostom AG, Carpenter MA, Kusek JW, et al. Homocysteine-lowering.

Cardiovascular Disease and Antihypertensives The RENAAL Trial Reference Brunner BM, and the RENAAL study group. Effects of losartan on renal and cardiovascular.

Scottish National Burden of Disease, Injuries and Risk Factors study:

Associate Professor, Honorary Consultant Cardiologist

Patient populations by study group figure 10

EMPHASIS-HF Extended Follow-up

Teaching Tool: Blood Pressure Classification

RAAS Blockade: Focus on ACEI

The percentage of subjects with de novo development of renal function impairment (GFR

Cardiac Biomarkers.

Nat. Rev. Cardiol. doi: /nrcardio

A. Heart failure: A challenge to the healthcare delivery system

Selected Causes of Cardiac Injury PEACE Trial High-Sensitivity Biomarker Substudy.

COPD Hospitalizations for Elderly Medicare Beneficiaries

Lowering of SBP by 20 mm Hg Reduces Cardiovascular Risk by Half

Association between cardiovascular disease, cardiovascular risk factors and chronic obstructive pulmonary disease (COPD) on mortality. Association between.

Prevalence of comorbidities in pooled studies of patients with chronic obstructive pulmonary disease (COPD). Prevalence of comorbidities in pooled studies.

Time to death from diabetes diagnosis for propensity-matched sample adjusted for age, gender, race, and other conditions. Time to death from diabetes diagnosis.

An ACCORD BP sub-analysis HR: 1.06; 95%CI: ; P=0.61

M. T. Svendsen1,2. ,, M. T. Ernst3. , K. E. Andersen1,2,4, F

An ACCORD BP sub-analysis HR: 1.06; 95%CI: ; P=0.61

Morbidity and mortality benefits with statin use in observational studies on a logarithmic scale. Morbidity and mortality benefits with statin use in observational.

Low/moderate intensity statins High intensity statins

Figure 8. Stroke prevention strategy in patients with AF

Low/moderate intensity statins High intensity statins

Presentation transcript:

Heart failure and comorbidities Analysis of the European Heart Failure Pilot Survey van Deursen VM et al. Co-morbidities in patients with heart failure: an analysis of the European Heart Failure Pilot Survey. Europ J Heart Fail. 2014;16:103-111.

Zoom on patients with comorbidities in Europe Comorbidities frequently accompany heart failure, leading to increased morbidity and mortality, and decreased quality of life. 3226 outpatients with chronic heart failure analysed AIM OF THE ANALYSIS Assessing the - prevalence, - prognostic implications, - determinents, and - regional variation, of their comorbidities. van Deursen VM et al. Co-morbidities in patients with heart failure: an analysis of the European Heart Failure Pilot Survey. Europ J Heart Fail. 2014;16:103-111.

Prevalence of comorbidities in heart failure …the most prevalent being… Chronic kidney disease Anemia Diabetes COPD Stroke 41% 74% 29% 29% Proportion of HF patients suffering from at least 1 comorbidity 15% 11% The number of comorbidities increases with the severity of heart failure. van Deursen VM et al. Co-morbidities in patients with heart failure: an analysis of the European Heart Failure Pilot Survey. Europ J Heart Fail. 2014;16:103-111.

Prognostic implications of comorbidities in heart failure Prognostic implications of comorbidities are assessed by population attributable risks (PARs*), corresponding to the % of all-cause mortality in the population attributable to the comorbidity: Chronic Kidney Disease Anemia Diabetes COPD 41% (95% CI, 29-51%) 37% (95% CI, 27-46%) 14% (95% CI, 5-–23%) 10% (95% CI, 3-16%) * “PAR can be described as the reduction in mortality that would be observed if the population was entirely unexposed to a certain c-morbidity, compared with the mortality pattern in patients without that comorbidity” van Deursen VM et al. Co-morbidities in patients with heart failure: an analysis of the European Heart Failure Pilot Survey. Europ J Heart Fail. 2014;16:103-111.

Determinents and regional variations of comorbidities in heart failure Patients with comorbidities: - older - more advanced heart failure (reflected by a higher NYHA class) - higher prevalence of hypertension and AF although a causal relationship cannot be established based on the data. - more comorbidities  more clinical signs of congestion (elevated JVP or peripheral oedema) - less likely to be receiving evidence-based therapies, such as ACEis, ARBs, and β-blockers. Patients with heart failure of ischemic aetiology had more comorbidities. Across various European regions, there are marked differences in prevalence and prognostic implications of comorbidities. Patients with increasing numbers of comorbidities have an increasing risk of both mortality and heart failure hospitalization. van Deursen VM et al. Co-morbidities in patients with heart failure: an analysis of the European Heart Failure Pilot Survey. Europ J Heart Fail. 2014;16:103-111.