scholarly journals Frequency of Cardiovascular Complications and Its Association with Prognosis of COVID-19 Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Hossein Mazaherpour ◽  
Masoumeh Soofian ◽  
Elham Farahani ◽  
Fatemeh Masfari Farahani ◽  
Ehsanollah Ghaznavi Rad ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Troponin I ◽  
Cardiovascular Complications ◽  
Cardiac Complications ◽  
Age Difference ◽  
Creatine Kinase Mb ◽  
Significant Difference ◽  
Artery Disease ◽  
Underlying Diseases ◽  
Electrocardiogram Ecg

Coronavirus disease 2019 (COVID-19) may lead to acute respiratory disease; cardiovascular, gastrointestinal, and coagulation complications; and even death. One of the major complications is cardiovascular disorders, including arrhythmias, myocarditis, pericarditis, and acute coronary artery disease. The aim of this study was to evaluate the frequency of cardiovascular complications and to determine its association with the prognosis of COVID-19 patients. In a prospective analytic study, 137 hospitalized COVID-19 patients were enrolled. During hospitalization, an electrocardiogram (ECG) was performed every other day, and laboratory tests such as cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) were done 0, 6, and 12 hours after admission. These tests were repeated for patients with chest pain or ECG changes. Patients were categorized into three groups (improved, complicated, and expired patients) and assessed for the rate and type of arrhythmias, cardiac complications, lab tests, and outcomes of treatments. There was no significant relationship among the three groups related to primary arrhythmia and arrhythmias during treatment. The most common arrhythmia during hospitalization and after treatment was ST-T fragment changes. There was a significant age difference between the three groups ( P = 0.001 ). There was a significant difference among the three groups for some underlying diseases, including diabetes mellitus ( P = 0.003 ) and hyperlipidemia ( P = 0.004 ). In our study, different types of arrhythmias had no association with patients’ outcomes but age over 60 years, diabetes mellitus, and hyperlipidemia played an important role in the prognosis of COVID-19 cases.

scholarly journals Type I Diabetes Mellitus Increases the Cardiovascular Complications of Influenza Virus Infection

2021 ◽  
Vol 11 ◽  
Author(s):  
Jane E. Sinclair ◽  
Conor J. Bloxham ◽  
Han Chiu ◽  
Keng Yih Chew ◽  
Jake Russell ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Virus Infection ◽  
Type I Diabetes ◽  
Cardiovascular Complications ◽  
Left Ventricular ◽  
Cardiac Complications ◽  
Type I ◽  
Diabetic Mice ◽  
Infected Control ◽  
Creatine Kinase Mb

People with diabetes mellitus are susceptible to both cardiovascular disease and severe influenza A virus infection. We hypothesized that diabetes also increases risks of influenza-associated cardiac complications. A murine type 1 (streptozotocin-induced) diabetes model was employed to investigate influenza-induced cardiac distress. Lung histopathology and viral titres revealed no difference in respiratory severity between infected control and diabetic mice. However, compared with infected control mice, infected diabetic mice had increased serum cardiac troponin I and creatine-kinase MB, left ventricular structural changes and right ventricular functional alterations, providing the first experimental evidence of type I diabetes increasing risks of influenza-induced cardiovascular complications.

scholarly journals A Risk Stratification Model for Cardiovascular Complications during the 3-Month Period after Major Elective Vascular Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Mladjan Golubovic ◽  
Dragana Stanojevic ◽  
Milan Lazarevic ◽  
Velimir Peric ◽  
Tomislav Kostic ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Vascular Surgery ◽  
European Society ◽  
Troponin I ◽  
Risk Index ◽  
High Sensitivity ◽  
Cardiovascular Complications ◽  
Cardiac Complications ◽  
Significant Difference ◽  
Hs Crp

Introduction. The Revised Cardiac Risk Index (RCRI) is an extensively used simple risk stratification tool advocated by the European Society of Cardiology and European Society of Anesthesiology (ESC/ESA). Purpose. The aim of this study was to find the best model for predicting 3-month cardiovascular complications in elective major vascular surgical patients using preoperative clinical assessment, calculation of the RCRI and Vascular Physiological and Operative Severity Score for the enumeration of mortality and morbidity (V-POSSUM) scores, and the preoperative levels of N-terminal brain natriuretic peptide (NT pro-BNP), high-sensitivity troponin I (hs TnI), and high-sensitivity C-reactive protein (hs CRP). Materials and Methods. We included 122 participants in a prospective, single-center, observational study. The levels of NT pro-BNP, hs CRP, and hs TnI were measured 48 hours prior to surgery. During the perioperative period and 90 days after surgery the following adverse cardiac events were recorded: myocardial infarction, arrhythmias, pulmonary edema, acute decompensated heart failure, and cardiac arrest. Results. During the first 3 months after surgery 29 participants (23.8%) had 50 cardiac complications. There was a statistically significant difference in the RCRI score between participants with and without cardiac complications. ROC analysis showed that a combination of RCRI with hs TnI has good discriminatory power (AUC 0.909, p<0,001). By adding NT pro-BNP concentrations to the RCRI+hs TnI+V-POSSSUM combination we obtained the model with the best predictive power for 3-month cardiac complications (AUC 0.963, p<0,001). Conclusion. We need to improve preoperative risk assessment in participants scheduled for major vascular surgery by combining their clinical scores with biomarkers. Therefore, it is possible to identify patients at risk of cardiovascular complications who need adequate preoperative diagnosis and treatment.

scholarly journals Cardiac Complications in COVID-19: A Systematic Review and Meta-analysis

2021 ◽  
Vol 24 (2) ◽  
pp. 152-163
Author(s):  
Mehrdad Sahranavard ◽  
Arash Akhavan Rezayat ◽  
Mohammad Zamiri Bidary ◽  
Alireza Omranzadeh ◽  
Farahnaz Rohani ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Myocardial Injury ◽  
Troponin I ◽  
Meta Analysis ◽  
Cardiovascular Complications ◽  
Incidence Rates ◽  
Cardiac Complications ◽  
P Value ◽  
Creatine Kinase Mb ◽  
Ctni Level

Background: The newly emerged coronavirus disease 2019 (COVID-19) seems to involve different organs, including the cardiovascular system. We systematically reviewed COVID-19 cardiac complications and calculated their pooled incidences. Secondarily, we compared the cardiac troponin I (cTnI) level between the surviving and expired patients. Methods: A systematic search was conducted for manuscripts published from December 1, 2019 to April 16, 2020. Cardiovascular complications, along with the levels of cTnI, creatine kinase (CK), and creatine kinase MB (CK-MB) in hospitalized PCR-confirmed COVID-19 patients were extracted. The pooled incidences of the extracted data were calculated, and the unadjusted cTnI level was compared between the surviving and expired patients. Results: Out of 1094 obtained records, 22 studies on a total of 4,157 patients were included. The pooled incidence rate of arrhythmia was 10.11%. Furthermore, myocardial injury had a pooled incidence of 17.85%, and finally, the pooled incidence for heart failure was 22.34%. The pooled incidence rates of cTnI, CK-MB, and CK elevations were also reported at 15.16%, 10.92%, and 12.99%, respectively. Moreover, the pooled level of unadjusted cTnI was significantly higher in expired cases compared with the surviving (mean difference = 31.818, 95% CI = 17.923-45.713, P value <0.001). Conclusion: COVID-19 can affect different parts of the heart; however, the myocardium is more involved.

Impact of the period of the day on mortality and major cardiovascular complications after vascular surgeries

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F.A.M Cardozo ◽  
T Artioli ◽  
B Caramelli ◽  
D Calderaro ◽  
P.C Yu ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
Total Mortality ◽  
Mortality Rates ◽  
Cardiovascular Complications ◽  
Cardiac Complications ◽  
Funding Source ◽  
Confounding Variables ◽  
Significant Difference ◽  
One Year ◽  
Night Period

Abstract Introduction Patients submitted to arterial vascular surgeries are at a high risk of postoperative cardiac and non-cardiac complications, therefore developing strategies to lower perioperative complications is essential to optimize outcomes for this subgroup. Recent studies have suggested that the period of the day in which surgeries are performed may influence postoperative major cardiovascular complications but there is still no evidence of this association in vascular surgeries. Purpose Our goal is to evaluate whether the period of the day in which surgeries are performed may influence mortality and cardiovascular outcomes in patients undergoing non-cardiac vascular procedures. Methods Patients who underwent non-cardiac vascular surgeries between 2012 and 2018 were prospectively included at our cohort. For this analysis, subjects were categorized into two groups: those who underwent surgery in the morning (7am - 12am) and those who underwent surgery in the afternoon/night (12:01pm - 6:59am). The primary endpoints were to compare the incidence of major adverse cardiac events (MACE - acute myocardial infarction, acute heart failure, arrhythmias, and cardiovascular death) and total mortality between morning and afternoon/night surgeries within 30 days and one year. The secondary endpoint was the incidence of perioperative myocardial injury (PMI) in both groups. PMI was defined as an absolute elevation of high-sensitivity cardiac troponin T (hs-cTnT) concentrations ≥14ng/L. Multivariable analysis using Cox proportional regression (with Hazard Ratio – HR and Confidence Interval – 95% CI) was performed to adjust for confounding variables, including emergency and urgent surgeries. Results Of 1267 patients included, 1002 (79.1%) underwent vascular surgery in the morning and 265 (20.9%) in the afternoon/night. After adjusting for confounding variables, the incidence of MACE at 30 days was higher among those who underwent surgery in the afternoon/night period (37.4% vs 20.4% – HR 1.43, 95% CI: 1.10–1.85; p=0.008). Mortality rates were also elevated in the afternoon/night group (21.5% vs 9.9%, HR 1.59, 95% CI: 1.10–2.29; p=0.013). After one-year of follow-up the worst outcomes persisted in patients operated in the afternoon/night: higher incidence of MACE (37.7% vs 21.2%, HR 1.37, 95% CI: 1.06–1.78; p=0.017) and mortality (35.8% vs 17.6%, HR 1.72, 95% CI 1.31–2.27; p&lt;0.001). There was no significant difference in the incidence of PMI between groups (p=0.8). Conclusions In this group of patients, being operated in the afternoon/night period was independently associated with increased mortality rates and incidence of MACE. Mortality and MACE at one year Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): FAPESP - Fundação de Amparo a Pesquisa do Estado de São Paulo

scholarly journals Impact of Coronary Artery Disease and Diabetes Mellitus on the Long-Term Follow-Up in Patients after Retrograde Recanalization of the Femoropopliteal Arterial Region

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Joanna Wojtasik-Bakalarz ◽  
Zoltan Ruzsa ◽  
Tomasz Rakowski ◽  
Andreas Nyerges ◽  
Krzysztof Bartuś ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Of Death ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Artery Disease ◽  
The Impact

The most relevant comorbidities in patients with peripheral artery disease (PAD) are coronary artery disease (CAD) and diabetes mellitus (DM). However, data of long-term follow-up of patients with chronic total occlusion (CTO) are scarce. The aim of the study was to assess the impact of CAD and DM on long-term follow-up patients after superficial femoral artery (SFA) CTO retrograde recanalization. In this study, eighty-six patients with PAD with diagnosed CTO in the femoropopliteal region and at least one unsuccessful attempt of antegrade recanalization were enrolled in 2 clinical centers. Mean time of follow-up in all patients was 47.5 months (±40 months). Patients were divided into two groups depending on the presence of CAD (CAD group: n=45 vs. non-CAD group: n=41) and DM (DM group: n=50 vs. non-DM group: n=36). In long-term follow-up, major adverse peripheral events (MAPE) occurred in 66.6% of patients with CAD vs. 36.5% of patients without CAD and in 50% of patients with DM vs. 55% of non-DM subjects. There were no statistical differences in peripheral endpoints in both groups. However, there was a statistically significant difference in all-cause mortality: in the DM group, there were 6 deaths (12%) (P value = 0.038). To conclude, patients after retrograde recanalization, with coexisting CTO and DM, are at higher risk of death in long-term follow-up.

Study of Lipid Profile in Diabetes Mellitus with and without Hypertension

2019 ◽  
Vol 5 (1) ◽  
pp. 31-36
Author(s):  
Jay Jha ◽  
Varun Malhotra ◽  
Om Jha ◽  
Shivani Gupta
Keyword(s):  
Diabetes Mellitus ◽  
Study Design ◽  
Serum Triglyceride ◽  
Control Group ◽  
Diabetic Patients ◽  
Serum Triglyceride Level ◽  
Balanced Diet ◽  
Significant Difference ◽  
Artery Disease ◽  
Lipid Abnormalities

Introduction Alterations in the lipid metabolism have been reported in the subject of diabetes mellitus. They may be influenced by the presence of hypertension. Aims The present study was undertaken to estimate the serum lipids profiles of diabetics with and without hypertension. Study design The study design is experimental with comparative study method, Methodology The sample size taken is 80 which is divided into four groups as A group of 20 healthy individuals of age 20-70 years, other B group of 20 diabetic patients without Hypertension, other C group of 20 hypertensive patients without diabetes and the rest 20 diabetic patients along with hypertension of age 20-70 years of D group. They were matched with respect to various lipid parameters such as total cholesterol, Triglycerides, lipoprotein ratio etc. with control group A. Place and duration of study: the study took place at Santosh group of institutions between August 2013 to August 2016. Result The serum cholesterol levels were significantly higher in hypertensives without diabetics and in diabetics with hypertension as compared to normal controls. No significant difference in the serum triglyceride level was observed among various groups in this study. The ?: ? lipoprotein ratio was found to be affected in all the groups as compared to controls with maximum ratio in diabetics without hypertension and in hypertension without diabetes. Patients who were suffering from diabetes and hypertension were at a maximum risk of developing atherosclerosisand its complications such as coronary artery disease. Diabetics with hypertension had significant higher levels of cholesterol as compared to that of without hypertension. The diabetics with hypertension had lipid abnormalities because of diabetic element in them rather than the hypertension. All the groups studied except the controls were found to be increasingly susceptible to the risk of atherosclerosis and its complications. This risk was found to be maximum in diabetics with hypertension rather than diabetics or hypertensive’s alone. Conclusion The need for right balanced diet, regular exercise and a stress free life is essential for prevention and management of diabetes and hypertension. 

Utility of Platelet Indices in Assessing the Risk of Coronary Artery Disease in Patients of Diabetes Mellitus

2020 ◽  
Author(s):  
Ayesh Khatoon ◽  
Shakti Kumar Yadav ◽  
Sompal Singh ◽  
Harsh Vardhan Singh ◽  
Namrata Sarin
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diabetic Patients ◽  
Platelet Volume ◽  
Distribution Width ◽  
Type 2 Dm ◽  
Significant Difference ◽  
Artery Disease

Abstract Background: Platelet volume indices (PVI) such as mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR), are the indicators of increased platelet activity which may play a role in development of vascular complications in diabetic patients. This study was performed to evaluate and compare the platelet volume indices such as MPV, PDW, P-LCR in patients of type 2 diabetes mellitus (DM) with and without manifested coronary artery disease in order to identify their usefulness in determining the risk for development of coronary complications.Methods: Analytical cross - sectional study included 150 patients of which 100 patients were diagnosed as type 2 DM and 50 apparently healthy controls. The study cases were divided into two groups based on presence or absence of coronary artery disease. Group A included 50 cases of type 2 DM without manifested coronary artery disease and group B included 50 cases of type 2 DM with manifested coronary artery disease. PVI was obtained using automated cell counter.Results: MPV, PDW, P-LCR were significantly higher in diabetics as compared to controls subjects (P < 0.001 for all). However, no statistically significant difference was found between diabetics with and without manifested coronary artery disease.Conclusions: The study showed higher PVI in diabetic subjects when compared to control subjects, but no difference between patients with and without manifested coronary artery disease suggesting that various other factors might be associated with the pathogenesis of CAD in patients of DM.

Abstract 14559: Prognostic Utility of Cardiac Markers in Covid-19 Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ahmad Damati ◽  
Kok Hoe Delcos Chan ◽  
Iyad Farouji ◽  
Amr Al-ramahi ◽  
Patel Bhavic ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Univariate Analysis ◽  
Cardiovascular Complications ◽  
Hospitalized Patients ◽  
Multivariable Logistic Regression Analysis ◽  
Cardiac Markers ◽  
Significant Difference ◽  
The Us ◽  
Prognostic Utility ◽  
Artery Disease

Introduction: SARS-CoV-2 infection has been associated with a multiple cardiovascular complications. It is not known if cardiac markers can be used for outcome prediction in the US population. Methods: We conducted a retrospective study on patients ≥ 18 years old with confirmed COVID 19, who were admitted to our hospital between 03/15/2020 and 05/25/2020. Individuals were included if they had a baseline troponin and brain natriuretic peptide (BNP) available, and if their outcome by the end of the study period was well defined as discharge alive, or deceased. Univariate and multivariate logistic regression methods were employed to identify the cardiac markers associated with mortality in COVID-19 patients. Results: The total number of confirmed COVID-19 hospitalized patients during the study period was 348, after excluding patients who did not have cardiac markers available, 233 patients were included in the study, 75 (32%) expired, and 158 (68%) were discharged alive. The median age was 65 years old, and ranged from 22 to 101 years old. 140 males and 93 females. Comorbidities were present in 201 (86%) patients, with hypertension (65%) being the most common, followed by obesity (55%), diabetes mellitus (DM) (44%) and coronary artery disease (27%). Mechanical ventilation was required for 61 patients of whom 42 expired. In univariate analysis, we found a significant difference in history of chronic kidney disease defined by eGFR <45ml/min (p=0.046), DM (p=0.043), initial SOFA (p=0.017), troponin (p=0.001), BNP (p=0.043), CRP (p=<0.0001), LDH (p=<0.0001) and ferritin (p=<0.0001) between survivors and non-survivors. With multivariable logistic regression analysis, the only values that had an odds of survival were a low troponin (odds ratio [OR] 0.17; 95% confidence interval [CI], 0.04-0.52), a low SOFA (OR 0.72, CI 0.50-0.94) and a low CRP (OR 0.87, CI 0.87-0.94). Conclusions: This retrospective cohort study of hospitalized patients with COVID-19 suggests an independent association of increased troponin as risk factor for death in COVID-19 patients. Cardiac troponin has been reported as potential prognostic marker in the China cohort. To our knowledge, we are first to demonstrate the utilization of troponin as mortality predictor in the US population.

Cardiovascular Deaths among CAPD Patients

1983 ◽  
Vol 3 (3_suppl) ◽  
pp. 23-26 ◽  
Author(s):  
George Wu
Keyword(s):  
Heart Disease ◽  
De Novo ◽  
Plasma Cholesterol ◽  
Hypertensive Heart Disease ◽  
Cardiovascular Complications ◽  
First Year ◽  
Antihypertensive Medications ◽  
Significant Difference ◽  
Artery Disease ◽  
Similar Risk

Forty-four of the 508 CAPD patients in Toronto died of cardiovascular complications during the period september 1977 -October 1982. More than 80% of these patients had evidence of ischemic or hypertensive heart disease before commencement of CAPD. The survival of CAPD patients, who were free of cardiac problems before starting CAPD, was significantly better than those who had angina pectoris, myocardial infarction or cardiomegaly at the onset of CAPD. The de novo incidence of ischemic heart disease in patients between ages 40 and 59 (n = 70) was 8.8% at the end of the first year, and 15%() at the end of the second year. These figures were comparable to those reported for hemodialysis patients but worse than those in nonuremic patients with similar risk factors. After starting CAPD, 68.2% of the initially hypertensive patients became normotensive without taking any medication, and 25.8%() became normotensive with a reduced dose of antihypertensive medications. There was no statistically significant difference between the mean fasting plasma cholesterol and triglyceride levels of patients with and those without coronary artery disease.

scholarly journals The correlation of 30- and 90-day mortality rates with Hs-troponin I values measured in patients diagnosed with paroxysmal supraventricular tachycardia in emergency service

2019 ◽  
pp. 102490791987142
Author(s):  
Erdem Kurt ◽  
Rohat AK ◽  
Şebnem Zeynep Eke Kurt ◽  
Suphi Bahadırlı ◽  
Tuba Cimilli Öztürk
Keyword(s):  
Supraventricular Tachycardia ◽  
Large Scale ◽  
Emergency Service ◽  
Troponin I ◽  
International Classification Of Diseases ◽  
Mortality Rates ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Significant Difference ◽  
Classification Of Diseases ◽  
Artery Disease

Background: This study aims to determine the relationship between troponin levels and 30- and 90-day mortality rates in patients who applied to emergency service with paroxysmal supraventricular tachycardia. Materials and methods: The data of our study were obtained from the retrospective screening of the files of 321 patients who applied to the emergency department between 1 January 2015 and 31 December 2016 with International Classification of Diseases diagnosis with I47.1 (supraventricular tachycardia). Unstable patients, patients under 18 years, and patients with comorbidities that could increase troponin levels did not participate in the study. A total of 159 patients diagnosed with paroxysmal supraventricular tachycardia were included in the study. These patients’ files were examined, and their examination and anamnesis information at the time of admission to hospital, demographic characteristics, and applied treatments were analyzed. The 30- and 90-day mortality rates of the patients were examined. Results: The study was carried out with 159 patients. Troponin was positive in 25 (15.7%) cases, while it was negative in 134 (84.3%) cases. There was no significant difference between the two groups in terms of 30- and 90-day mortality rates. Coronary artery disease was found to be higher in patients with positive troponin than patients with negative troponin. Conclusion: No significant difference was found between patients with positive troponin values compared to patients with negative troponin values in terms of 30- and 90-day mortality rates. We believe that prospective observational studies or large-scale retrospective studies will better elucidate this issue.

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