European journal of internal medicine
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Eur. J. Intern. Med. · Feb 2025
Multicenter StudyHyperchloremic metabolic acidosis potentially benefiting sodium bicarbonate therapy: A multi-center cohort study.
The use of sodium bicarbonate for metabolic acidosis has been a topic of debate, primarily due to the lack of clinical efficacy evidence. This study aims to identify which types of patients with various acid-base balance parameters can benefit from sodium bicarbonate therapy. ⋯ This study identified an interaction between baseline chloride and sodium bicarbonate therapy on patient survival. Hyperchloremic metabolic acidosis may potentially benefit from sodium bicarbonate therapy. Further prospective randomized controlled studies are warranted.
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Eur. J. Intern. Med. · Feb 2025
Multicenter StudyDifferent impact of chronic kidney disease in older patients with heart failure according to frailty.
Chronic kidney disease (CKD) and frailty are often present in older patients with heart failure (HF). Our aim was to evaluate the association of CKD and frailty in one-year mortality in a cohort of older (≥75 years) outpatients with HF METHODS: Our data come from the FRAGIC study ("impacto de la FRAGilidad y otros síndromes Geriátricos en el manejo clínico y pronóstico del paciente anciano ambulatorio con Insuficiencia Cardíaca"), a multicenter prospective registry conducted in 16 cardiology services in Spain which included ≥75 years outpatients with HF. Renal function was assessed according to CKD-EPI formula. A comprehensive geriatric assessment was performed and frailty was identified according to visual mobility scale (frail if VMS≥2). Survival rates were analyzed by Cox regression model. ⋯ Most HF patients≥75 years have renal dysfunction. CKD is a marker of worse prognosis in elderly patients with chronic HF, but it does not independently associate one-year mortality in the presence of frailty.
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Eur. J. Intern. Med. · Jan 2025
Randomized Controlled Trial Multicenter StudyAssociation between trajectory of systolic blood pressure and outcomes in heart failure patients with preserved ejection fraction (HFpEF).
The optimal systolic blood pressure (SBP) in heart failure patients with preserved ejection fraction (HFpEF) remains controversial. We aim to assess the SBP trajectory and prognosis in HFpEF. ⋯ The decreasing or increasing SBP trajectory is associated with a high risk of cardiovascular events in HFpEF, suggesting a stable SBP trajectory group (≈130 mmHg) have lower incidence of cardiovascular events and mortality. Trials are necessary to determine the optimal SBP in HFpEF.
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Eur. J. Intern. Med. · Jan 2025
Multicenter StudyThe impact of the COVID-19 Pandemic on hypertension phenotypes (ESH ABPM COVID-19 study).
The COVID-19 pandemic had a major impact on medical care. This study evaluated the influence of the pandemic on blood pressure (BP) control and hypertension phenotypes as assessed by office and 24-hour ambulatory BP monitoring (ABPM). ⋯ These results indicate a negative impact of the COVID-19 pandemic on BP control assessed by hypertension phenotypes.
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Eur. J. Intern. Med. · Jan 2025
Multicenter StudySystolic blood pressure, a predictor of mortality and life expectancy following heart failure hospitalization, 2010-2023.
Optimal systolic blood pressure (SBP) targets for the treatment of hospitalized acute decompensated heart failure (ADHF) patients are not known. ⋯ In hospitalized ADHF patients, SBP <130 mmHg at discharge or within 30 days post-discharge was linked to higher mortality and YLL, while SBP ≥130 mmHg or improvement to ≥130 mmHg post-discharge led to better short and long-term outcomes. Further research is needed to understand the mechanisms and benefits of SBP optimization.