Suboptimal guideline adherence is associated with higher MortalitY and hospitalization Rates in patieNts with heArt failure and reduced ejection fraction: The SMYRNA Study

[No Abstract Available

C-Reactive Protein/Albumin Ratio Predicts Acute Kidney Injury in Patients With Moderate to Severe Chronic Kidney Disease and Non-ST-Segment Elevation Myocardial Infarction

In this study, we aimed to evaluate the predictive value of admission C-reactive protein/albumin ratio (CAR) for acute kidney injury (AKI) in cases with moderate to severe chronic kidney disease (CKD) not on dialysis who presented with non-ST-segment elevation myocardial infarction (NSTEMI) and underwent coronary angiography (CAG). This cross-sectional and observational study included 420 NSTEMI patients. The study population was categorized based on the CAR tertiles as groups T1, T2, and T3. The primary outcome of the study was AKI development; 92 (21.9%) cases developed AKI. The frequency of AKI was significantly higher in the T3 group compared with the T2 and T1 groups (34% vs 17% vs 14%, P 0.20 predicted AKI development with a sensitivity of 74% and a specificity of 45%. We observed that the CAR may be a promising inflammatory parameter for AKI in NSTEMI patients with moderate to severe CKD after CAG

The effect of idiopathic premature ventricular complexes on left ventricular ejection fraction

Aim Current literature lacks a definitive threshold of idiopathic premature ventricular complex (PVC) burden for predicting cardiomyopathy (CMP). The main objective of the present study was to evaluate relationship between the PVC burden and left ventricular ejection fraction (LVEF). Method This multicenter, cross-sectional study included 341 consecutive patients with more than 1,000 idiopathic PVC in 24 hr of Holter monitoring admitted to the cardiology clinics between January 2019 and May 2019 in the nineteen different centers. The primary outcome was the LVEF measured during the echocardiographic examination. Result Overall, the median age was 50 (38-60) and 139 (49.4\%) were female. Percentage of median PVC burden was 9\% (IQR: 4\%-17.4\%). Median LVEF was found 60\% (55-65). We used proportional odds logistic regression method to examine the relationship between continuous LVEF and candidate predictors. Increase in PVC burden (\%) (regression coefficient (RE) -0.644 and 95\% CI -1.063, -0.225, p < .001), PVC QRS duration (RE-0.191 and 95\% CI -0.529, 0.148, p = .049), and age (RE-0.249 and 95\% CI -0.442, -0.056, p = .018) were associated with decrease in LVEF. This inverse relationship between the PVC burden and LVEF become more prominent when PVC burden was above 5\%. A nomogram developed to estimate the individual risk for decrease in LVEF. Conclusion Our study showed that increase in PVC burden \%, age, and PVC QRS duration were independently associated with decrease in LVEF in patients with idiopathic PVC. Also, inverse relationship between PVC burden and LVEF was observed in lower PVC burden than previously known

Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction: The ATA study

Objective: Despite recommendations from heart failure guidelines on the use of pharmacologic and device therapy in patients with heart failure with reduced ejection fraction (HFrEF), important inconsistencies in guideline adherence persist in practice. The aim of this study was to assess adherence to guideline-directed medical and device therapy for the treatment of patients with chronic HFrEF (left ventricular ejection fraction <= 40%)