Predictors of early and late mortality after transcatheter aortic valve implantation : a multicenter retrospective Chinese study

Background: Patients undergoing TAVR constitute a high-risk population given their comorbidities and out-of-hospital mortality rates remain high despite significant improvements in the overall procedural outcomes. Objectives: The objective of this study was to determine the early and late mortality rates following transfemoral transcatheter aortic valve replacement (TAVR) and identify the risk factors for poor outcomes. Methods: This study population examined patients extracted from 43 publicly funded hospitals in Hong Kong between 2010 and 2019. The study constitutes retrospective analysis of mortality outcomes for severe aortic stenosis patients undergoing TAVR. The primary end points include out-of-hospital 30-day, 1-year, 1–2-year, and 2–5-year mortality rates. Results: A total of 448 patients underwent TAVR and were included into the study. The rates of mortality following TAVR were 1.7%, 3.3%, 1.3%, and 0.22% at 30 days, 1, 1–2, and 2–5 years, respectively. Age and chronic renal failure (CRF) were concluded to be associated with postprocedural mortality. Further analysis of the baseline echocardiographic parameters revealed a higher prevalence of right atrial enlargement (RAE) and tricuspid and pulmonary regurgitation in the deceased subgroup. Conclusion: We report the 30-day, 1-, 1–2-, and 2–5-year all-cause mortality for TAVR of 1.7%, 3.3%, 1.3%, and 0.22% at 30 days. Factors associated with a higher prevalence of mortality include age, CRF, RAE, and tricuspid and pulmonary regurgitation

In-hospital mortality in SARS-CoV-2 stratified by hemoglobin levels : a retrospective study

This study is to estimate in-hospital mortality in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients stratified by hemoglobin (Hb) level. Patients were stratified according to hemoglobin level into two groups, that is, Hb 100 g/L. A total of 6931 patients were included. Of these, 6377 (92%) patients had hemoglobin levels >100 g/L. The mean age was 44 ± 17 years, and 66% of the patients were males. The median length of overall hospital stay was 13 days [2; 31]. The remaining 554 (8%) patients had a hemoglobin level 100 g/L (52, 0.82%). Risk factors associated with increased mortality were determined by multi- variate analysis. The Kaplan-Meier survival analysis showed hemoglobin as a predictor of mortality. Cox proportional hazards regression coefficients for hemoglobin for the HB ≤ 100 category of hemoglobin were significant, B = 2.79, SE = 0.17, and HR = 16.34, p < 0.001. Multivariate logistic regression showed Hb < 100 g/L had a higher cumu- lative all-cause in-hospital mortality (22.4% vs. 0.8%; adjusted odds ratio [aOR], 0.33; 95% [CI]: [0.20–0.55]; p < 0.001). In this study, hemoglobin levels <100 g/L were found to be an independent predictor of in-hospital mortality

Prevalence of the Pro12Ala missense mutation in the <i>PPARG2</i> gene in Kuwaiti patients with primary knee osteoarthritis

<b>Background and Objectives:</b> Peroxisome proliferator-activated receptors (PPARs) play an important role in a number of cellular and metabolic functions. This study was carried out to determine the prevalence of a missense mutation (Pro12Ala) in the <i>PPARG2</i> gene in Kuwaiti Arab patients with primary knee osteoarthritis (OA) and healthy controls with the aim of identifying a possible association. <b>Design and Setting:</b> A prospective cross-sectional study carried out at three major teaching hospitals (referral centers) in the country over a one-year period. <b>Patients and Methods :</b>The prevalence of <i>PPARG2</i> gene Pro12Ala missense mutation was determined in 104 Kuwaiti Arab patients with primary knee OA and 111 ethnically matched healthy controls. The prevalence of this Pro12Ala missense mutation was also determined in clinical subgroups of OA patients divided on the basis of age at onset, function and radiologic grading. <b>Results</b> : The Pro-Pro genotype of the <i>PPARG2</i> gene Pro12Ala missense mutation was detected in 95/104 (91.3&#x0025;) cases compared to 111/111 (100&#x0025;) in the control subjects. The heterozygous Pro-Ala genotype was detected in 9/104 (8.7&#x0025;) of the OA patients, while it was not detected in any of the controls. The Ala-Ala genotype was not detected in any of the OA patients or the controls. No significant differences were detected in the <i>PPARG2</i> gene Pro12Ala genotypes in the subgroups of patients classified on the basis of age at onset, functional assessment using Lequesne&#x2032;s functional index, and radiological grading using Kellgren-Lawrence (K-L) grading. <b>Conclusions</b> : This study found no significant association between the <i>PPARG2</i> gene Pro12Ala missense mutation and knee OA. However, the presence of the Pro-Pro genotype of the <i>PPARG2</i> gene mutation has a protective effect against development of OA

Design and rationale of gulf documentation of ambulatory sick patients with heart failure (Gulf DYSPNEA) registry

Aim: The aim of this study is to describe the clinical characteristics of ambulatory patients with chronic heart failure (HF) in the Arabian Gulf and to examine several aspects including types of HF, causes, and adherence to management guidelines. Methods: Gulf documentation of ambulatory sick patients with HF (Gulf DYSPNEA) registry is a multicenter, cross-sectional study, recruiting adult ambulatory HF patients from 24 hospitals in five Arabian Gulf countries. Consecutive patients are recruited prospectively from participating clinics with no follow-up data collection. Recruitment started on November 07, 2016 and will stop when 3,500 patients are enrolled in this study. Collected data explore demographics, baseline patient characteristics, symptoms, previous medical history, comorbidities, physical signs, presenting electrocardiogram, echocardiographic findings, types of HF, and management. Conclusion: This registry is expected to provide useful data on several important aspects and features of ambulatory patients with chronic HF in Arabian Gulf countries. The trial registration number is “ClinicalTrials.gov number, NCT02793180”

Correction: Acute Myocardial Infarction and Acute Heart Failure in the Middle East and North Africa: Study Design and Pilot Phase Study Results from the PEACE MENA Registry.

[This corrects the article DOI: 10.1371/journal.pone.0236292.]

Acute myocardial infarction and acute heart failure in the Middle East and North Africa: Study design and pilot phase study results from the PEACE MENA registry.

BackgroundThis pilot study describes the overall design and results of the Program for the Evaluation and Management of the Cardiac Events registry for the Middle East and North Africa (MENA) Region.MethodsThis prospective, multi-center, multi-country study included patients hospitalized with acute myocardial infarction (AMI) and/or acute heart failure (AHF). We evaluated the clinical characteristics, socioeconomic and educational levels, management, in-hospital outcomes, and 30-day mortality rate of patients that were admitted to one tertiary-care center in each of 14 Arab countries in the MENA region.ResultsBetween 22 April and 28 August 2018, 543 AMI and 381AHF patients were enrolled from 14 Arab countries (mean age, 57±12 years, 82.5% men). Over half of the patients in both study groups had low incomes with limited health care coverage, and limited education. Nearly half of the cohort had a history of diabetes mellitus, hypertension, or hypercholesterolemia. Among patients with ST-elevation myocardial infarctions, 56.4% received primary percutaneous interventions, 24% received thrombolysis, and 19.5% received no acute reperfusion therapy. The main causes of AHF were ischemic heart diseases (55%) and primary valvular heart diseases (15%). The in-hospital and 30-day mortality rates were 2.0% and 3.5%, respectively, for AMI, and 5.4% and 7.0%, respectively, for AHF.ConclusionsThis pilot study revealed a high prevalence of cardiovascular risk factors in patients with AMI and AHF in Arab countries, and low levels of socioeconomic and educational status. Future phases of the study will improve our understanding of the impact that these factors have on the management and outcomes of cardiac events in these patient populations