Cargando…
Cardio-renal and cardio-hepatic interactions predict cardiovascular events in elderly patients with heart failure
BACKGROUND: The composite Model for End-Stage Liver Disease Excluding International Normalized Ratio Score (MELD-XI) is a novel tool to evaluate cardio-renal and cardio-hepatic interactions in patients with advanced heart failure (HF). However, its prognostic ability remains unclear in elderly HF pa...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7584193/ https://www.ncbi.nlm.nih.gov/pubmed/33095810 http://dx.doi.org/10.1371/journal.pone.0241003 |
_version_ | 1783599546243219456 |
---|---|
author | Okano, Takahiro Motoki, Hirohiko Minamisawa, Masatoshi Kimura, Kazuhiro Kanai, Masafumi Yoshie, Koji Higuchi, Satoko Saigusa, Tatsuya Ebisawa, Soichiro Okada, Ayako Shoda, Morio Kuwahara, Koichiro |
author_facet | Okano, Takahiro Motoki, Hirohiko Minamisawa, Masatoshi Kimura, Kazuhiro Kanai, Masafumi Yoshie, Koji Higuchi, Satoko Saigusa, Tatsuya Ebisawa, Soichiro Okada, Ayako Shoda, Morio Kuwahara, Koichiro |
author_sort | Okano, Takahiro |
collection | PubMed |
description | BACKGROUND: The composite Model for End-Stage Liver Disease Excluding International Normalized Ratio Score (MELD-XI) is a novel tool to evaluate cardio-renal and cardio-hepatic interactions in patients with advanced heart failure (HF). However, its prognostic ability remains unclear in elderly HF patients. METHODS AND RESULTS: From July 2014 to July 2018, patients hospitalized for HF were prospectively recruited at 16 centers. Clinical features, laboratory findings, and echocardiography results were assessed prior to discharge. Cardiovascular (CV) death and HF re-hospitalization were recorded. Of the 676 patients enrolled, 264 (39.1%) experienced CV events throughout a 1-year median follow-up period. Patients with high MELD-XI were predominantly male and had a higher prevalence of NYHA III/IV, history of HF admission, hyperuricemia, ventricular tachycardia, anemia, and ischemic heart disease. In Kaplan-Meyer analysis, patients with higher MELD-XI (≥11) scores showed a worse prognosis than did those with lower (<11) scores (log-rank p≤0.001). Multivariate Cox proportional hazards testing revealed MELD-XI as an independent predictor of CV events (HR: 1.033, 95% CI: 1.006–1.061, p = 0.015) after adjusting for age, gender, body mass index, NYHA III/IV, prior HF hospitalization, systolic blood pressure, ischemic etiology, ventricular tachycardia, anemia, BNP, and left ventricular ejection fraction. CONCLUSIONS: Cardio-renal and cardio-hepatic interactions predicted CV events in aged HF patients. |
format | Online Article Text |
id | pubmed-7584193 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-75841932020-10-27 Cardio-renal and cardio-hepatic interactions predict cardiovascular events in elderly patients with heart failure Okano, Takahiro Motoki, Hirohiko Minamisawa, Masatoshi Kimura, Kazuhiro Kanai, Masafumi Yoshie, Koji Higuchi, Satoko Saigusa, Tatsuya Ebisawa, Soichiro Okada, Ayako Shoda, Morio Kuwahara, Koichiro PLoS One Research Article BACKGROUND: The composite Model for End-Stage Liver Disease Excluding International Normalized Ratio Score (MELD-XI) is a novel tool to evaluate cardio-renal and cardio-hepatic interactions in patients with advanced heart failure (HF). However, its prognostic ability remains unclear in elderly HF patients. METHODS AND RESULTS: From July 2014 to July 2018, patients hospitalized for HF were prospectively recruited at 16 centers. Clinical features, laboratory findings, and echocardiography results were assessed prior to discharge. Cardiovascular (CV) death and HF re-hospitalization were recorded. Of the 676 patients enrolled, 264 (39.1%) experienced CV events throughout a 1-year median follow-up period. Patients with high MELD-XI were predominantly male and had a higher prevalence of NYHA III/IV, history of HF admission, hyperuricemia, ventricular tachycardia, anemia, and ischemic heart disease. In Kaplan-Meyer analysis, patients with higher MELD-XI (≥11) scores showed a worse prognosis than did those with lower (<11) scores (log-rank p≤0.001). Multivariate Cox proportional hazards testing revealed MELD-XI as an independent predictor of CV events (HR: 1.033, 95% CI: 1.006–1.061, p = 0.015) after adjusting for age, gender, body mass index, NYHA III/IV, prior HF hospitalization, systolic blood pressure, ischemic etiology, ventricular tachycardia, anemia, BNP, and left ventricular ejection fraction. CONCLUSIONS: Cardio-renal and cardio-hepatic interactions predicted CV events in aged HF patients. Public Library of Science 2020-10-23 /pmc/articles/PMC7584193/ /pubmed/33095810 http://dx.doi.org/10.1371/journal.pone.0241003 Text en © 2020 Okano et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Okano, Takahiro Motoki, Hirohiko Minamisawa, Masatoshi Kimura, Kazuhiro Kanai, Masafumi Yoshie, Koji Higuchi, Satoko Saigusa, Tatsuya Ebisawa, Soichiro Okada, Ayako Shoda, Morio Kuwahara, Koichiro Cardio-renal and cardio-hepatic interactions predict cardiovascular events in elderly patients with heart failure |
title | Cardio-renal and cardio-hepatic interactions predict cardiovascular events in elderly patients with heart failure |
title_full | Cardio-renal and cardio-hepatic interactions predict cardiovascular events in elderly patients with heart failure |
title_fullStr | Cardio-renal and cardio-hepatic interactions predict cardiovascular events in elderly patients with heart failure |
title_full_unstemmed | Cardio-renal and cardio-hepatic interactions predict cardiovascular events in elderly patients with heart failure |
title_short | Cardio-renal and cardio-hepatic interactions predict cardiovascular events in elderly patients with heart failure |
title_sort | cardio-renal and cardio-hepatic interactions predict cardiovascular events in elderly patients with heart failure |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7584193/ https://www.ncbi.nlm.nih.gov/pubmed/33095810 http://dx.doi.org/10.1371/journal.pone.0241003 |
work_keys_str_mv | AT okanotakahiro cardiorenalandcardiohepaticinteractionspredictcardiovasculareventsinelderlypatientswithheartfailure AT motokihirohiko cardiorenalandcardiohepaticinteractionspredictcardiovasculareventsinelderlypatientswithheartfailure AT minamisawamasatoshi cardiorenalandcardiohepaticinteractionspredictcardiovasculareventsinelderlypatientswithheartfailure AT kimurakazuhiro cardiorenalandcardiohepaticinteractionspredictcardiovasculareventsinelderlypatientswithheartfailure AT kanaimasafumi cardiorenalandcardiohepaticinteractionspredictcardiovasculareventsinelderlypatientswithheartfailure AT yoshiekoji cardiorenalandcardiohepaticinteractionspredictcardiovasculareventsinelderlypatientswithheartfailure AT higuchisatoko cardiorenalandcardiohepaticinteractionspredictcardiovasculareventsinelderlypatientswithheartfailure AT saigusatatsuya cardiorenalandcardiohepaticinteractionspredictcardiovasculareventsinelderlypatientswithheartfailure AT ebisawasoichiro cardiorenalandcardiohepaticinteractionspredictcardiovasculareventsinelderlypatientswithheartfailure AT okadaayako cardiorenalandcardiohepaticinteractionspredictcardiovasculareventsinelderlypatientswithheartfailure AT shodamorio cardiorenalandcardiohepaticinteractionspredictcardiovasculareventsinelderlypatientswithheartfailure AT kuwaharakoichiro cardiorenalandcardiohepaticinteractionspredictcardiovasculareventsinelderlypatientswithheartfailure |