OPTIMAL-HF is a pragmatic, cluster randomized, single-blind intervention trial that will be conducted at an outpatient clinic in Argentina. The trial will assess the effectiveness of an individualized-based alert system compared to usual care in improving GDMT optimization at 90 days in patients with HFrEF.

开始日期2024-01-15

申办/合作机构

Instituto Cardiovascular De Buenos Aires SA

NCT05972746

/ RecruitingN/A

Telemonitoring Program With Electronic Alerts to Improve Outcomes in the Vulnerable Phase After Hospitalization for Heart Failure: A Pragmatic Clinical Trial TREAT - Vulnerable HF

This pragmatic clinical trial aims to evaluate the impact of a telemonitoring program with an electronic alert system compared to standard treatment on the perception of self-care in patients after hospitalization for decompensated HF at 3 months post-discharge. And secondarily to evaluate its impact on clinical events, NT-proBNP and efficacy and safety to facilitate the use and titration of the recommended drugs in patients with reduced ejection fraction at 90 days.

开始日期2022-10-07

申办/合作机构

Instituto Cardiovascular De Buenos Aires SA

NCT04549701

/ CompletedN/A

Inferior Vena CAVA and Lung UltraSound-guided Therapy in Acute Heart Failure: a Randomized Controlled Pilot Trial (CAVAL US-AHF Study)

Between 25% and 30% of patients hospitalized for acute heart failure (AHF) are readmitted within 90 days after discharge. Mostly due to persistent congestion on discharge. However, as the optimal evaluation of decongestion is not clearly defined, it is necessary to implement new tools to identify subclinical congestion to guide treatment.

开始日期2022-03-20

申办/合作机构

Instituto Cardiovascular De Buenos Aires SA

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2025-05-01·Nutrition, Metabolism and Cardiovascular Diseases

Impact of diabetes on epicardial reperfusion and mortality in a contemporary STEMI population undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry

Article

作者: Paladino, Roberto ; Milicic, Davor ; Bachini, Juan Pablo ; Oliveira, Dinaldo C ; Casella, Gianni ; Burgadha, Mohammed Abed ; Caiazzo, Gianluca ; Verdoia, Monica ; Galasso, Gennaro ; Cirrincione, Giuseppe ; Antti, Ylitalo ; Rodríguez-Sanchez, Robert ; Jensen, Lisette Okkels ; Ordoñez, Santiago ; Faurie, Benjamin ; Algowhary, Magdy ; Silveira, João António Brum ; Kao, Hsien-Li ; Pereira, Helder ; Moura Joaquim, Rodrigo de ; Arpad, Lux ; Juzar, Dafsah Arifa ; Kala, Petr ; Calmac, Lucian ; De Luca, Giuseppe ; Lee, Michael Kang-Yin ; Lukito, Antonia Anna ; Mert, Kadir Ugur ; D'Uccio, Fortunato Scotto ; Tam, Frankie Chor-Cheung ; Ojeda, Francisco Bosa ; Loh, Poay Huan ; Uguz, Berat ; Roura I Ferrer, Gerard ; Bessonov, Ivan ; Mantis, Christos ; Bakraceski, Nikola ; Díez Gil, José Luis ; Martínez-Luengas, Iñigo Lozano ; Kochiadakis, George ; Bellemain-Appaix, Anne ; Ganyukov, Vladimir ; Forés, Juan Sanchis ; Lung, Aaron Wong Sung ; Kidawa, Michal ; Zimbakov, Zan ; Kedhi, Elvin ; Menichelli, Maurizio ; Versaci, Francesco ; Rodriguez, Alfredo ; Pessah, Gustavo ; Cercek, Miha ; Kanakakis, John ; Becerra-Munoz, Victor M ; Alexopulos, Dimitrios ; Donazzan, Luca ; Fabris, Enrico ; Teles, Rui ; Milewski, Marek ; Dirksen, Maurits ; Suryapranata, Harry ; Zoni, Rodrigo ; Zilio, Filippo ; Uribe, Carlos E ; Lehtola, Heidi ; Vincenzo, Guiducci ; Scheller, Bruno ; Lucia, Marinucci ; Manzo, Stephane ; Moreu, Josè ; Davlouros, Periklis ; Kovarnik, Tomas ; Gabrielli, Gabriele ; Berg, Jurrien Ten ; Kraaijeveld, Adriaan ; Carrillo, Xavier ; Lamelas, Pablo ; Scoccia, Alessandra ; Parodi, Guido ; Rios, Xacobe Flores ; Rocha, Alex ; Özkan, Alev Arat ; von Birgelen, Clemens ; Savonitto, Stefano ; Vignali, Luigi ; Cortese, Giuliana ; Nardin, Matteo ; Quadros, Alexandre ; Yamac, Aylin Hatice ; Flavien, Vincent ; Gutierrez Barrios, Alejandro

BACKGROUND AND AIMDiabetes has been shown in last decades to be associated with a significantly higher mortality among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary PCI (PPCI). Therefore, the aim of current study was to evaluate the impact of diabetes on times delays, reperfusion and mortality in a contemporary STEMI population undergoing PPCI, including treatment during the COVID pandemic.METHODS AND RESULTSThe ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry involving PPCI centers from Europe, Latin America, South-East Asia and North-Africa, including patients treated from 1st of March until June 30, 2019 and 2020. Primary study endpoint of this analysis was in-hospital mortality. Secondary endpoints were postprocedural TIMI 0-2 flow and 30-day mortality. Our population is represented by 16083 STEMI patients. A total of 3812 (23,7 %) patients suffered from diabetes. They were older, more often males as compared to non-diabetes. Diabetic patients were less often active smokers and had less often a positive family history of CAD, but they were more often affected by hypertension and hypercholesterolemia, with higher prevalence of previous STEMI and previous CABG. Diabetic patients had longer ischemia time, had more often anterior MI, cardiogenic shock, rescue PCI and multivessel disease. They had less often out-of-hospital cardiac arrest and in-stent thrombosis, received more often a mechanical support, received less often a coronary stent and DES. Diabetes was associated with a significantly impaired postprocedural TIMI flow (TIMI 0-2: 9.8 % vs 7.2 %, adjusted OR [95 % CI] = 1.17 [1.02-1.38], p = 0.024) and higher mortality (in-hospital: 9.1 % vs 4.8 %, Adjusted OR [95 % CI] = 1.70 [1.43-2.02], p < 0.001; 30-day mortality: 10.8 % vs 6 %, Adjusted HR [95 % CI] = 1.46 [1.26-1.68], p < 0.001) as compared to non-diabetes, particularly during the pandemic.CONCLUSIONSOur study showed that in a contemporary STEMI population undergoing PPCI, diabetes is significantly associated with impaired epicardial reperfusion that translates into higher in-hospital and 30-day mortality, particularly during the pandemic.

2025-05-01·Current Problems in Cardiology

Identifying low-risk in patients with worsening heart failure with short hospital stay: A comparison of risk scores in predicting 30-day risk events

Review

作者: Baro Vila, Rocío Consuelo ; Ballari, Franco Nicolás ; Malano, Damian ; Burgos, Lucrecia María ; Diez, Mirta ; de Bortoli, María Antonella ; Arias, Ramiro

INTRODUCTIONHeart failure (HF) is a leading cause of hospitalization worldwide, with high mortality rates and significant economic burden. To address the issue outpatient strategies (day-care diuretics) to avoid unplanned ED visits and reduce HF hospitalizations. However, the identification of low risk patients worsening heart failure (WHF) who could benefit from outpatient treatment remains poorly documented.OBJECTIVEWe aimed to evaluate the accuracy of multiple scores in predicting the risk of 30-day events in patients WHF who underwent brief hospitalizations.METHODSWe conducted a retrospective analysis of a prospective and consecutive cohort of WHF patients with hospitalizations of less than 72 h at a tertiary care hospital between 2015 and 2020. The risk of 30-day all-cause mortality was evaluated using the OPTIMIZE-HF, GWTG-HF, and ADHERE risk scores. And the secondary endpoint was the combined unplanned visit or readmission for worsening HF or death at 30 days. The risk of events in low-risk populations was analyzed by tertiles within the most predictive model.RESULTSAmong the 200 included patients (mean age: 75.5 ± 12 years; 62% male), 95.9% had a 30-day follow-up, with an overall mortality rate of 4% and a secondary composite endpoint of 14%. AUC-ROC for the prediction of 30-day all-cause mortality were 0.76 (95% CI 0.59-0.93), 0.66 (95% CI 0.46-0.86), and 0.64 (95% CI 0.44-0.85) for OPTIMIZE-HF, GWTG-HF, and ADHERE, respectively. For the secondary combined event, the AUC-ROC was 0.70 (95% CI 0.59-0.79) for OPTIMIZE-HF, GWTG-HF 0.67 (0.56-0.77) and ADHERE 0.67 (0.56 -0.77). The three scores had good calibration (Hosmer-Lemeshow goodness-of-fit test >0.05). Among the low-risk patients (n = 76, OPTIMIZE-HF score <32), the incidence of mortality and combined events at 30 days was 1.3% and 5.3%, respectively. Kaplan-Meier survival analysis showed that low risk patients had lower risk of the combined event (log rank p < 0.006).CONCLUSIONAmong WHF patients with short hospital stays, the OPTIMIZE-HF score exhibited superior predictive ability compared to other scores and may serve as a valuable tool for assessing the risk of death or combined events at 30 days. Utilizing the OPTIMIZE-HF risk score could aid in identifying low-risk patients who might benefit from outpatient management of AHF in a day-care diuretic clinic.

2025-04-16·Current Vascular Pharmacology

Validation of the Zwolle Risk Score in STEMI Patients Undergoing Primary PCI: Insights from the ISCAS-STEMI COVID-19 Registry

Article

作者: Gutierrez Barrios, Alexandro ; Kedhi, Elvin ; Bessonov, Ivan ; Davlouros, Periklis ; Pessah, Gustavo ; Donazzan, Luca ; Quadros, Alexandre ; Roura i Ferrer, Gerard ; Parodi, Guido ; Zimbakov, Zan ; Rodriguez, Alfredo ; Marinucci, Lucia ; Nardin, Matteo ; Gabrielli, Gabriele ; Kochiadakis, George ; Ordonez, Santiago ; Bosa Ojeda, Francisco ; flores rios, Xacobe ; Kanakakis, John ; Kraaijeveld, Adriaan ; Wong Sung Lung, Aaron ; Faurie, Benjamin ; Cercek, Miha ; Fabris, Enrico ; Alexopulos, Dimitrios ; Calmac, Lucian ; Carillo, Xavier ; Versaci, Francesco ; Moreu, Jose ; Menichelli, Maurizio ; Arpad, Lux ; Antti, Ylitalo ; Cirrincione, Giuseppe ; Casella, Gianni ; Rocha, Alex ; Algowhary, Magdy ; Kidawa, Michal ; Díez Gil, José Luis ; Huan LOH, Poay ; Arat Ozkan, Alev ; Bakraceski, Nikola ; C. Oliveira, Dinaldo ; Chor-Cheung Tam, Frankie ; Kao, Hsien-Li ; Vincent, Flavien ; Savonitto, Stefano ; De Luca, Giuseppe ; Uguz, Berat ; Vignali, Luigi ; Kovarnik, Tomas ; Manzo-Silbermann, Stephane ; Mantis, Christos ; Cortese, Giuliana ; T Dirksen, Maurits ; Miličić, Davor ; Lamelas, Pablo ; Di Uccio, Fortunato Scotto ; Lehtola, Heidi ; Lukito, Antonia Anna ; Ugur Mert, Kadir ; Zoni, Rodrigo ; Kala, Petr ; Boccalatte, Marco ; Brum Silveira, Joao Antonio ; Malewski, Marek ; Zilio, Filippo ; Lozano Martínez-Luengas, Inigo ; E Uribe, Carlos ; ten Berg, Jurrien ; Sanchis Fores, Juan ; Kang-yin Lee, Michael ; Saint Joy, Veauthyelau ; Galasso, Gennaro ; Teles, Rui ; Scoccia, Alessandra ; Suryapranata, Harry ; Manuel Becerra-Munoz, Victor ; Paladino, Roberto ; Bachini, Jaun Pablo ; Scheller, Bruno ; de Moura Joaquim, Rodrigo ; Caiazzo, Gianluca ; Burgadha, Mohammed Abed ; Hatice Yamac, Aylin ; Verdoia, Monica ; Arifa Juzar, Dafsah ; Ganyukov, Vladimir ; Pereira, Hélder ; Guiducci, Vincenzo ; Jensen, Lisette Okkels ; Von Birgelen, Clemens ; Arellano-Serrano, Carlos

Background:Several scores have been developed to facilitate risk stratification and early discharge following primary angioplasty, particularly the Zwolle Risk Score (ZRS). However, validation in large-sized studies is still lacking. Therefore, the aim of the current study was to validate the use of the ZRS in a contemporary global population, including patients who were treated during the SARS-CoV-2 pandemic and enrolled in a large intercontinental observational study.Methods:The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry involving primary PCI centers from Europe, Latin America, South-East Asia, and NorthAfrica, including patients treated from March 1st until June 30th, in 2019 and 2020]. ZRS was calculated for each patient. The patients were additionally categorized according to the following values of the ZRS [≤3; 4-6; 7-9; ≥10]. Our study outcomes were in-hospital and 30-day mortality. The discriminatory capacity of the ZRS was assessed by the area under the ROC curve [c statistic] as an index of model performance.Results:Our population is represented by 16084 STEMI patients undergoing mechanical reperfusion enrolled in 109 centers. The score showed a very good performance in the predicting mortality both in-hospital [AUC=0.83 [0.82-0.85], p<0.0001] and at 30- day follow-up [AUC=0.82 [0.81-0.84, p<0.0001]. The results were confirmed when the ZRS was separately applied to patients treated in 2019 and 2020, with good stability across time. ZRS was able to identify a large cohort [n=10672, 66.3%] of low-risk patients [score ≤3] with a very low mortality rate at 2 days [1%] and between 3 and 10 days [0.7%], with a very good negative predictive value for in-hospital [98.3%] and 30-day mortality [97.7%], with similar results in 2019 and 2020.Conclusion:This study is the first to demonstrate the good prognostic performance of the ZRS in a large-scale contemporary global multicenter validation set. Similar results were obtained both in the pre-pandemic and the COVID-19 era. ZRS ≤3 identified a very low-risk population that could be discharged early, even during the COVID-19 pandemic, with expected advantages in the availability of hospital beds and nursing staff, costs of medical care, and in-hospital risk of contagion.

项与 Instituto Cardiovascular De Buenos Aires SA 相关的新闻（医药）

2023-07-13

·美通社

ICBA：世界卫生组织和粮农组织重申，阿斯巴甜是安全的

华盛顿 2023年7月14日 /美通社/——根据世界卫生组织 (WHO) 和联合国粮食及农业组织 (FAO) 今天（星期四）联合发布的一项明确的新研究结果，添加阿斯巴甜的食品和饮料是安全的粮农组织/世卫组织食品添加剂联合专家委员会 (JECFA) 审查了数十年的高质量证据和现实世界中的消费数据，设定了阿斯巴甜的每日可接受摄入量 (ADI)，只要摄入量低于每日可接受摄入量，一个人一生中每天可以安全食用它。 ICBA执行主任Kate Loatman对世卫组织和粮农组织的研究结果表示赞赏，并评论道： "全球领先健康和食品安全专家的这一明确结论再次证实了阿斯巴甜是安全的。世卫组织和粮农组织这一具有里程碑意义、经过严格审查的研究结果，进一步让设法控制糖和热量的摄入的消费者确信阿斯巴甜是安全的。 JECFA的这项综合结论，即阿斯巴甜是安全的，是建立在四十多年来的大量科学证据，以及90多个国家食品安全当局明确证实它的安全性的基础上。" Loatman女士针对国际癌症研究机构 (IARC) 在6月29日首次公开的一个观点补充道： "非食品安全机构的国际癌症研究机构，基于其自己认为"有限"和"不充分"的证据，现在正式承认阿斯巴甜的危害并不比芦荟和数百种其他同类物质造成的危害更大。虽然国际癌症研究机构披露的观点可能不必要地让消费者对猜测感到困惑，但国际癌症研究机构遵从粮农组织/世卫组织食品添加剂联合专家委员会（此委员会重申阿斯巴甜是安全的）的观点，认为他们是全面评估阿斯巴甜的安全性的适当全球权威机构。" 关于国际饮料协会理事会： ICBA是成立于1995年的国际非政府组织，代表全球非酒精饮料行业的利益。 ICBA成员包括国家和地区饮料协会以及国际饮料公司，这些公司在逾200个国家和地区生产、分销和销售各种非酒精气泡饮料和非充气饮料，包括软性饮料、运动饮料、能量饮料、瓶装水、加味水和\/或强化水、即饮茶和咖啡、100%水果或蔬菜汁、花蜜和果汁饮料以及乳制品饮料。如需了解更多信息，请访问： https:\/\/www.icba-net.org\/

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