European journal of internal medicine
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Eur. J. Intern. Med. · Mar 2013
Multicenter Study Comparative StudyEducation, household wealth and blood pressure in Albania, Armenia, Azerbaijan and Ukraine: findings from the Demographic Health Surveys, 2005-2009.
While socioeconomic gradients in cardiovascular disease have been well established in high-income countries, this relationship is not well understood in middle-income countries. ⋯ There is compelling evidence that wealth and education gradients affect the probability of HTN for women in Albania, Armenia, and Azerbaijan, and for men in Albania.
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Eur. J. Intern. Med. · Mar 2013
Multicenter Study Comparative StudyLong-term survival following acute heart failure: the Acute Heart Failure Database Main registry (AHEAD Main).
The in-hospital mortality of patients with acute heart failure (AHF) is reported to be 12.7% and mortality on day 30 after admission 17.2%. Less information is known about the long-term prognosis of those patients discharged after hospitalization. As such, the aim of this study was to investigate long-term survival in a cohort of patients who had been hospitalized for AHF and then discharged. ⋯ The AHEAD Main registry provides up-to-date information on the long-term prognosis of patients hospitalized with AHF. The 3-year survival of patients following day 30 of admission was 64.5%. Higher age, LV dysfunction, comorbidities and high levels of natriuretic peptides were the most powerful predictors of worse prognosis in long-term survival.
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Eur. J. Intern. Med. · Mar 2013
Multicenter Study Comparative StudyDiagnostic role of copeptin in patients presenting with chest pain in the emergency room.
Chest pain is a frequent symptom leading patients to the Emergency Room. Copeptin, the C-terminal fragment of arginin-vasopressin, is a marker of stressful situations. Recent studies showed that normal levels of copeptin combined with normal troponin accurately rule out the diagnosis of acute coronary syndrome (ACS). In this observational, prospective, multicenter study we evaluated if negative levels of copeptin combined with negative troponin (Tn-T) can correctly rule out the diagnosis of ACS and also of other life-threatening causes of chest pain. ⋯ The combined use of troponin and copeptin significantly improved the diagnostic accuracy of troponin alone both in ACS (STEMI and NSTEMI) and in other life-threatening diseases. Measurement of this marker might be therefore considered not only for a rule-out strategy but also as a warning sign of a life-threatening disease.
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Eur. J. Intern. Med. · Mar 2013
Comparative StudyEpidemiology and characteristics of hyponatremia in the emergency department.
Hyponatremia is the most common electrolyte abnormality and it is associated with increased morbidity and mortality. The aim of the study was to investigate the underlying causes and management of hyponatremia in an unselected population presenting with hyponatremia to the emergency department. ⋯ Thiazide diuretics and SIADH were dominating underlying causes of hyponatremia, however, the frequency of adequate diagnostic testing was low. The majority of patients were treated with sodium chloride infusion.
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Eur. J. Intern. Med. · Mar 2013
Comparative StudyConcomitant renal and hepatic dysfunctions in chronic heart failure: clinical implications and prognostic significance.
The cardio-renal syndrome is common and eGFR is an established biomarker in chronic heart failure (CHF). Recent findings also indicate a predictive role of liver function abnormalities such as GGT in CHF. We aimed to jointly investigate the characteristics and importance of renal and hepatic failure in CHF. ⋯ Impairment of renal and hepatic function is related to functional status and a poor prognosis in patients with mild to moderate heart failure. Concurrent involvement of both organs indicates disease progression and further elevates the hazard for adverse outcomes. Moreover, our data suggest that venous congestion rather than forward failure accounts for the development of renal and hepatic dysfunctions in these patients.