Document Detail


Long-term prognosis and risk factors for cardiac adverse events in patients with chronic systolic heart failure due to hypertension.
MedLine Citation:
PMID:  18619178     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The long-term prognosis and predictors of adverse cardiac events in hypertension-related chronic systolic heart failure (CHF) remain uncertain. Therefore, we sought to determine the major adverse cardiac events (MACE) in this group of patients. PATIENTS AND METHODS: One hundred and thirty two patients (83% males, age 48.6 +/- 8.2 years) in NYHA class II and III with hypertension-related chronic CHF were prospectively evaluated for three years. Hypertension was defined as blood pressure > or = 140/90 mmHg documented clinically twice for at least 5 years before the onset of CHF symptoms. All patients underwent coronary angiography to exclude coronary artery disease as a cause of CHF. Analysis of predictors of MACE (death, urgent heart transplantation and re-admission to the hospital due to CHF progression) during the 3 years of follow up was performed. RESULTS: After follow up the frequency of MACE was 41.7%. The independent predictors of MACE occurrence were as follows: the symptoms of depression [hazard ratio (HR) 2.58 (95% CI 1.44-4.63, p < 0.01)], end-diastolic diameter of the right ventricular (EDDRV) [HR 1.07 (95% CI 1.02-1.12, p < 0.01)] and D-dimers [HR 2.24 (95% CI 1.08-4.67, p < 0.05)]. To define optimal prognostic accuracy of EDDRV and D-dimers the receiver operating characteristics curve analysis was performed. The cut-off for EDDRV was 28 mm (sensitivity 50%, specificity 67.6%, area under curve [AUC] 0.64, p < 0.01) and for D-dimers 0.23 microg/ml, (sensitivity 58%, specificity 64.2%, AUC 0.62, p < 0.05). CONCLUSIONS: In analysed group the symptoms of depression, higher baseline right ventricular diastolic diameter and higher baseline D-dimers level were independent predictors of MACE.
Authors:
Bozena Szygu?a-Jurkiewicz; Aleksander Owczarek; Agata Dusza?ska; Jacek Sikora; Andrzej Lekston; Robert Pudlo; Romuald Wojnicz; Lech Polo?ski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Polskie Archiwum Medycyny Wewn?trznej     Volume:  118     ISSN:  0032-3772     ISO Abbreviation:  Pol. Arch. Med. Wewn.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-07-14     Completed Date:  2008-08-26     Revised Date:  2010-04-01    
Medline Journal Info:
Nlm Unique ID:  0401225     Medline TA:  Pol Arch Med Wewn     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  280-8     Citation Subset:  IM    
Affiliation:
III Department of Cardiology in Zabrze, Medical University of Silesia, Katowice, Poland. b.szygula@sccs.pl
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MeSH Terms
Descriptor/Qualifier:
Adult
Chronic Disease
Depression
Female
Fibrin Fibrinogen Degradation Products
Follow-Up Studies
Heart Failure, Systolic / etiology*,  mortality*
Humans
Hypertension / complications*
Male
Middle Aged
Patient Readmission
Prognosis
Risk Factors
Time Factors
Chemical
Reg. No./Substance:
0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D

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