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Heart failure diabetes mellitus

Hui Shao, Shuang Yang, Vivian Fonseca, Charles Stoecker, Lizheng Shi
OBJECTIVE: Health utility decrements associated with diabetes mellitus complications are essential for calculating quality-adjusted life-years (QALYs) in patients for use in economic evaluation of diabetes interventions. Previous studies mostly focused on assessing the impact of complications on health utility at event year based on cross-sectional data. This study aimed to separately estimate health utility decrements associated with current and previous diabetes complications. RESEARCH DESIGN AND METHODS: The Health Utilities Index Mark 3 (HUI-3) was used to measure heath utility in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial (N = 8713)...
February 19, 2019: PharmacoEconomics
Jihong Ma, Xiaodong Wang, Mao Zheng, Haizhu Yu, Junmin Ma, Xiaohang Li, Jingye Pan, Yueyue Huang
AIMS: To investigate the association between body mass index (BMI) and all-cause mortality in patients with type 2 diabetes mellitus (T2DM) and to determine any sex-specific differences in this association. METHODS: We retrospectively enrolled patients with T2DM and investigated the annual death data for seven years starting from 2010. All-cause mortality was calculated using Life Tables analysis. Multivariate Cox proportional hazards analysis was performed to identify the association between BMI and mortality...
February 18, 2019: Endocrine Research
Marketa Marvanova, Paul Jacob Henkel
OBJECTIVES: To summarize select continuing pharmacy education (CPE) topics and hours related to geriatric care completed by community, hospital/clinic, and long-term care (LTC)/consultant pharmacists in the previous 12 months, whether pharmacy workplace influenced topic selection or completion, and to describe CPE sources used by community versus hospital/clinic pharmacists. DESIGN: Cross-sectional survey (2017). SETTING AND PARTICIPANTS: Licensed pharmacists in North Dakota, South Dakota, Minnesota, Iowa, and Nebraska with primary practice settings in community pharmacies, hospitals, or clinics or those practicing as consultant pharmacists...
February 13, 2019: Journal of the American Pharmacists Association: JAPhA
Manuel Raya-Cruz, Antonio Payeras-Cifre, Lola Ventayol-Aguiló, Paz Díaz-Antolín
BACKGROUND: Skin and soft tissue infections (SSTIs) are a common cause of consultation, and complicated cases require hospitalization. We describe factors that are related to readmission and/or mortality of hospitalized patients diagnosed with SSTIs. METHODS: Retrospective review of hospital-admitted patients with a diagnosis of cellulitis, abscess, hidradenitis, fasciitis, and Fournier's gangrene. Cases from January 2002 to October 2015 were extracted from the diagnostic codification database of the Archives and Clinical Documentation Department...
February 15, 2019: International Journal of Dermatology
Prakash Deedwania, Tushar Acharya
Diabetes mellitus is a major risk factor for cardiovascular (CV) disease. Conversely, CV disease is responsible for a majority of the deaths in patients with diabetes. Many drug trials have concentrated on blood glucose (hemoglobin A1c ) reduction. This strategy, while reducing microvascular outcomes like nephropathy and neuropathy, has little or no effect on reducing macrovascular events like heart attack, stroke, and heart failure. It has been postulated that hypoglycemia may counterbalance some of the beneficial effects of anti-hyperglycemic agents, but this is not proven...
February 15, 2019: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Julio A Chirinos, Priyanka Bhattacharya, Anupam Kumar, Elizabeth Proto, Prasad Konda, Patrick Segers, Scott R Akers, Raymond R Townsend, Payman Zamani
Background Heterogeneity in the underlying processes that contribute to heart failure with preserved ejection fraction ( HF p EF ) is increasingly recognized. Diabetes mellitus is a frequent comorbidity in HF p EF , but its impact on left ventricular and arterial structure and function in HF p EF is unknown. Methods and Results We assessed the impact of diabetes mellitus on left ventricular cellular and interstitial hypertrophy (assessed with cardiac magnetic resonance imaging, including T1 mapping pregadolinium and postgadolinium administration), arterial stiffness (assessed with arterial tonometry), and pulsatile arterial hemodynamics (assessed with in-office pressure-flow analyses and 24-hour ambulatory monitoring) among 53 subjects with HF p EF (32 diabetic and 21 nondiabetic subjects)...
February 19, 2019: Journal of the American Heart Association
Stefan H Hohnloser, Hugh Calkins, Stephan Willems, Atul Verma, Richard Schilling, Ken Okumura, Matias Nordaby, Eva Kleine, Branislav Biss, Edward P Gerstenfeld
PURPOSE: To describe regional differences in patient characteristics, ablation procedures, and bleeding events in the RE-CIRCUIT study. RE-CIRCUIT was a prospective, multicenter study that captured data from different regions, providing an opportunity to understand the practices followed in various regions. The incidence of major bleeding events (MBEs) was significantly lower with uninterrupted dabigatran versus uninterrupted warfarin. METHODS: Patients were randomized to receive dabigatran 150 mg twice daily or warfarin...
February 13, 2019: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Thiago Quinaglia, Daniela C Oliveira, José Roberto Matos-Souza, Andrei C Sposito
Although long ago described, there is no established consensus regarding the real existence of Diabetic Cardiomyopathy (CMPDM). Due to its complex pathophysiology, it has been difficult for clinical and experimental research to establish clear connections between diabetes mellitus (DM) and heart failure (HF), as well as to solve the mechanisms of the underlying myocardial disease. However, the epidemiological evidence of the relationship of these conditions is undisputed. The interest in understanding this disease has intensified due to the recent results of clinical trials evaluating new glucose-lowering drugs, such as sodium-glucose transporter inhibitors 2, which demonstrated favorable responses considering the prevention and treatment of HF in patients with DM...
January 2019: Revista da Associação Médica Brasileira
Daniel J Gorski, Anne Petz, Christina Reichert, Sören Twarock, Maria Grandoch, Jens W Fischer
Diabetic patients are at a greater risk of heart failure due to diabetic cardiomyopathy and worsened outcome post-myocardial infarction. While the molecular mechanisms remain unclear, fibrosis and chronic inflammation are common characteristics of both conditions. Diabetes mellitus (types I and II) results in excessive hyaluronan (HA) deposition in vivo, and hyperglycemia stimulates HA synthesis for several cell types in vitro. HA-rich extracellular matrix contributes to fibrotic, hyperplastic and inflammatory disease progression...
February 12, 2019: Scientific Reports
Jessica L H Phillips, Alexander J Rondon, Chris Vannello, Yale A Fillingham, Matthew S Austin, P Maxwell Courtney
BACKGROUND: As alternative payment models increase in popularity for total joint arthroplasty (TJA), providers and hospitals now share the financial risk associated with unexpected readmissions. While studies have identified postacute care as a driver for costs in a bundle, the fiscal burden associated with specific causes of readmission is unclear. The purpose of this study is to quantify the additional costs associated with each of the causes of readmission following primary TJA. METHODS: We reviewed a consecutive series of primary TJA patients at our institution from 2015 to 2016 using claims data from the Centers for Medicare and Medicaid Services and Medicare Advantage patients from a single private insurer...
January 23, 2019: Journal of Arthroplasty
Neda Valizadeh, Kunal Suradkar, Ravi P Kiran
The aim of this study was to identify preoperative characteristics that may determine the need for emergency surgery for diverticulitis and assess postoperative outcomes for these patients when compared with elective surgery. All patients included in the ACS-NSQIP-targeted colectomy database from 2012 to 2013 who underwent colectomy with an underlying diagnosis of diverticulitis were included. Preoperative characteristics and 30-day postoperative outcomes were evaluated for patients who underwent elective versus emergent/urgent surgery using univariable and multivariable analyses...
November 1, 2018: American Surgeon
Christina M Ackerman, Marissa H Platner, Erica S Spatz, Jessica L Illuzzi, Xiao Xu, Katherine H Campbell, Graeme N Smith, Michael J Paidas, Heather S Lipkind
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of pregnancy-related death in the United States. (1) Identification of short-term indicators of cardiovascular morbidity has the potential to alter the course of this devastating disease among women. It has been established that hypertensive disorders of pregnancy (HDP) are associated with increased risk of cardiovascular disease 10-30 years after delivery; however, little is known about the association of hypertensive disorders of pregnancy with cardiovascular (CV) morbidity during the delivery hospitalization...
February 8, 2019: American Journal of Obstetrics and Gynecology
Kelly McHugh, Adam D DeVore, Jingjing Wu, Roland A Matsouaka, Gregg C Fonarow, Paul A Heidenreich, Clyde W Yancy, Jennifer B Green, Natasha Altman, Adrian F Hernandez
Heart failure with preserved ejection fraction (HFpEF) is now the most common form of HF, affecting over 3 million adults in the United States alone. HFpEF is a heterogenous syndrome. One important phenotype may be related to comorbid conditions, including diabetes mellitus (DM). DM has a prevalence of approximately 45% in HFpEF, but characteristics and outcomes of this population are poorly understood. In this review, the authors summarize data from several clinical trials of HFpEF therapeutics and provide original data from a large cohort using the Get With The Guidelines-HF registry, which together suggest that DM is associated with increased morbidity and long-term mortality in HFpEF...
February 12, 2019: Journal of the American College of Cardiology
Christina Stolzenburg Oxlund, Manan Pareek, Benjamin Schnack Brandt Rasmussen, Muthiah Vaduganathan, Tor Biering-Sørensen, Christina Byrne, Zaid Almarzooq, Michael Hecht Olsen, Deepak L Bhatt
BACKGROUND: It is unclear whether intensive blood pressure management is well-tolerated and affects risk uniformly across the body mass index (BMI) spectrum. METHODS: The randomized, controlled Systolic Blood Pressure Intervention Trial (SPRINT) included 9,361 individuals ≥50 years at high cardiovascular risk, without diabetes mellitus, and a systolic blood pressure 130-180 mmHg. Participants were randomized to intensive versus standard antihypertensive treatment and evaluated for the primary composite efficacy endpoint of acute coronary syndromes, stroke, heart failure, or cardiovascular death...
February 2, 2019: American Journal of Medicine
Naoya Yoshida, Hiroyuki Yamamoto, Hideo Baba, Hiroaki Miyata, Masayuki Watanabe, Yasushi Toh, Hisahiro Matsubara, Yoshihiro Kakeji, Yasuyuki Seto
OBJECTIVE: We aimed to elucidate whether minimally invasive esophagectomy (MIE) can be safely performed by reviewing the Japanese National Clinical Database. SUMMARY OF BACKGROUND DATA: MIE is being increasingly adopted, even for advanced esophageal cancer that requires various preoperative treatments. However, the superiority of MIE's short-term outcomes compared with those of open esophagectomy (OE) has not been definitively established in general clinical practice...
January 31, 2019: Annals of Surgery
Li Wang, Jiamei Li, Ya Gao, Ruohan Li, Jingjing Zhang, Dan Su, Tao Wang, Guang Yang, Xiaochuang Wang
BACKGROUND: Previous studies have found a connection between left coronary artery dominance and worse prognoses in patient with acute coronary syndrome, which remains a predominant cause of morbidity and mortality globally. The aim of this study was to investigate whether coronary dominance is associated with the incidence of acute inferior myocardial infarction (MI). METHODS: Between January 2011 and November 2014, 265 patients with acute inferior MI and 530 age-matched and sex-matched controls were recruited for a case-control study in the Second Affiliated Hospital of Xi'an Jiaotong University in Xi'an, China...
February 4, 2019: BMC Cardiovascular Disorders
Osamah M Alfayez, Majed S Al Yami, Mohannad Alshibani, Saad B Fallatah, Nasser M Al Khushaym, Razan Alsheikh, Nimer Alkhatib
The aim of this network meta-analysis (NMA) was to indirectly compare the cardiovascular (CV) safety of new antidiabetic medications in patients with type 2 diabetes mellitus (T2DM). DATA SYNTHESIS: A search of the Embase and MEDLINE databases was conducted systematically to identify cardiovascular outcome trials (CVOTs) of new antidiabetic medications (DPP-4 inhibitors, GLP-1 agonists and SGLT-2 inhibitors) in patients with T2DM. The primary outcomes were the composite endpoint of CV death, nonfatal MI, and nonfatal stroke (MACE), death from CV causes, nonfatal MI, nonfatal stroke and death from any cause...
January 31, 2019: Primary Care Diabetes
Steven G Chrysant, George S Chrysant
OBJECTIVES: Obesity has risen in the US and worldwide, and has become a major risk factor for type 2 diabetes mellitus (T2DM), hypertension, cardiovascular disease, and heart failure (HF), mostly HF with preserved ejection fraction (HFpEF). Also, the prevalence of HF is quite high in the US accounting for 6.6 million adults at present and is projected to reach 8.5 million by the year 2030 and is equally divided between HFpEF and heart failure reduced ejection fraction (HFrEF). Patients with HFpEF are resistant to treatment with drugs usually used for the treatment of HFrEF, but the reasons for this resistance are not clearly known...
February 4, 2019: Hospital Practice (Minneapolis)
Daniel J Friedman, Jeffrey G Gaca, Tongrong Wang, S Chris Malaisrie, David R Holmes, Jonathan P Piccini, Rakesh M Suri, Michael J Mack, Vinay Badhwar, Jeffrey P Jacobs, Eric D Peterson, Shein-Chung Chow, J Matthew Brennan
PURPOSE: Patients with atrial fibrillation (AF) undergoing cardiac surgery are at substantially increased risk for stroke. Increasing evidence has suggested that surgical left atrial appendage occlusion (S-LAAO) may have the potential to substantially mitigate this stroke risk; however, S-LAAO is performed in a minority of patients with AF undergoing cardiac surgery. We sought to identify factors associated with usage of S-LAAO. METHODS: In a nationally-representative, contemporary cohort (07/2011-06/2012) of older patients undergoing cardiac surgery with preoperative AF (n = 11,404) from the Medicare-linked Society of Thoracic Surgeons Adult Cardiac Surgery Database, we evaluated patient and hospital characteristics associated with S-LAAO use by employing logistic and linear regression models...
February 2, 2019: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
S C Yang, Y C Chiu, P H Liu, T J Hsieh, Y H Kao, Y K Tu
Benign prostatic hyperplasia is one of the most common diseases in the elderly male population. The urinary tract symptoms may increase the risk of falls and fractures. The results indicated that patients with benign prostatic hyperplasia could increase the risk of vertebral compression fractures in both the thoracic and lumbar spine and also hip fractures, but did not increase the risk of wrist fracture. INTRODUCTION: The relationship between benign prostatic hyperplasia and the development of fall-related fractures, especially vertebral compression fractures, has been seldom mentioned in the literature...
January 31, 2019: Osteoporosis International
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