Annals of medicine
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Multicenter Study
The identification and prediction of atrial fibrillation in coronary artery disease patients: a multicentre retrospective study based on Bayesian network.
Atrial fibrillation (AF) coexisting with coronary artery disease (CAD) remains a prevailing issue that often results in poor short- and long-term patient outcomes. Screening has been proposed as a method to increase AF detection rates and reduce the incidence of poor prognosis through early intervention. Nevertheless, due to the cost implications and uncertainty over the benefits of a systematic screening programme, the International Task Force currently recommends against screening. This study is to employ Bayesian networks (BN) for assessing the pre-test probability (PTP) of AF in patients with CAD. ⋯ The prediction model of AF with CAD constructed based on BN has high prediction performance and may provide a new tool for large-scale AF screening.
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Multicenter Study Observational Study
Diversity of heart failure phenotypes in transthyretin amyloid cardiomyopathy. More than just heart failure with preserved ejection fraction.
Current guidelines recommend suspecting transthyretin amyloid cardiomyopathy (ATTR-CM) in patients over 65 years of age with unexplained left ventricular (LV) hypertrophy in a non-dilated LV, heart failure (HF) and preserved ejection fraction (HFpEF), hypertrophic cardiomyopathy or severe aortic stenosis. However, there is evidence indicating a high prevalence of ATTR-CM in other HF phenotypes. As such, this study aimed to characterize the diversity of HF phenotypes of ATTR-CM by examining the LV ejection fraction and LV dilatation using echocardiography. ⋯ This study revealed significant variability in HF phenotypes among patients with ATTR-CM, from HFpEF without LV dilatation to HFrEF with severe LV dilatation. Relying solely on HFpEF for screening may lead to under-diagnosis. These findings suggest the need for more comprehensive diagnostic criteria beyond echocardiographic measures to improve ATTR-CM detection and management.
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A growing number of studies show that people with similar blood glucose levels have different levels of glycosylated haemoglobin (HbA1c), and relying only on HbA1c may lead to clinical decision-making errors. The haemoglobin glycation index (HGI) quantifies the difference in HbA1c among individuals and is strongly linked to the risk of cardiovascular disease. However, the connection between this phenomenon and the poor outcomes of patients with acute decompensated heart failure (ADHF) is currently unknown. ⋯ A high HGI was directly associated with a reduction in all-cause and CV deaths but was not associated with MACE. These findings may be helpful in the management of patients with ADHF.
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To investigate the effectiveness of the intervention with critical value management and push short messaging service (SMS), and to determine improvement in the referral rate of patients with positive hepatitis C antibody (anti-HCV). ⋯ The interventions of critical value management and push SMS were correlated with the referral rate of patients with positive anti-HCV.
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Chronic pain is an opioid use disorder (OUD) treatment barrier and associated with poor outcomes in OUD treatment including relapse. Fibromyalgia is a chronic pain condition related to central nervous system substrates that overlap with the brain disease model of OUD. We know of no studies that have looked at non-treatment seeking individuals, to see if fibromyalgia might represent a barrier to OUD treatment. Given many non-treatment-seeking individuals previously attempted recovery before experiencing relapse, and chronic pain is a known precipitant of relapse, fibromyalgia might be a currently unappreciated modifiable factor in OUD relapse and, potentially, a barrier to treatment reengagement among those not currently seeking treatment. This study aimed to determine if fibromyalgia is associated with greater odds of agreeing that 'I have tried to stop using opioids before, but pain caused me to relapse' among non-treatment seeking individuals with OUD. ⋯ This study provides early evidence that the presence of fibromyalgia may be associated with increased odds of pain-precipitated OUD relapse.