The American journal of cardiology
-
Multicenter Study Observational Study
Relation of Isolated Systolic Hypertension and Pulse Pressure to High-Sensitivity Cardiac Troponin-T and N-Terminal pro-B-Type Natriuretic Peptide in Older Adults (from the Atherosclerosis Risk in Communities Study).
Isolated systolic hypertension (ISH) and elevated pulse pressure (PP) are common blood pressure (BP) abnormalities in older adults, reflect poor vascular compliance, and can signify risk for cardiovascular outcomes. We sought to characterize the associations of ISH and widened PP with high-sensitivity Troponin-T (hs-cTnT; a marker of myocardial damage) and N-terminal pro-B-type natriuretic peptide (NT-proBNP; a marker of hemodynamic stress) levels in older adults. We performed a cross-sectional analysis of 5,251 Atherosclerosis Risk in Communities (ARIC) study participants without heart failure who attended visit 5 (2011 to 2013). ⋯ Increasing quartiles of PP were also significantly associated with both elevated hs-cTnT (p-for-trend <0.0001) and NT-proBNP (p-for-trend <0.0001). These associations were not modified by BP treatment status. In conclusion, ISH and wide PP are relatively common in older adults despite contemporary BP treatment and are associated with abnormalities in hs-cTnT and NT-pro BNP, findings that could guide personalized treatment of older patients with these BP aberrations.
-
Multicenter Study
Readmissions Following Isolated Coronary Artery Bypass Graft Surgery in the United States (from the Nationwide Readmissions Database 2010 to 2014).
Readmission following cardiac surgery is associated with poor outcomes and increased healthcare expenditure. However, a nationwide understanding of the incidence, cost, causes, and predictors of 30-day readmission following coronary artery bypass grafting is limited. The Nationwide Readmissions Database was used to identify all adult patients who underwent isolated coronary artery bypass grafting (CABG) with no other concomitant surgery between 2010 and 2014. ⋯ CABG performed at a high CABG volume hospital was protective of readmission (OR 0.95; 95% CI 0.91 to 0.99). In conclusion, we characterized using a national sample the incidence, causes, costs, and predictors of 30-day readmission following CABG. Targeting modifiable risk factors for readmission should be a priority to reduce rates of readmission and decrease healthcare expenditure.