Hyperuricemia is associated with poor outcomes in chronic heart failure (HF). We aimed to evaluate whether uric acid (UA) alone or in combination with N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a good predictor of all-cause mortality, HF hospitalization, and the composite endpoint of HF hospitalization or all-cause mortality in chronic HF. UA and NT-proBNP levels were evaluated retrospectively in 861 chronic HF patients with a left ventricular ejection fraction of ≤50%. The patients were compared by dividing them into 4 groups according to the cut-off values of UA and NT-proBNP. Serum UA concentrations were ≥ 7.0 mg/dL in 46.5% of the subjects. With a median follow-up of 30 months, 201 (23.3%) patients died and 308 (35.8%) patients were hospitalized during the study. The all-cause mortality rate was higher in the hyperuricemic group than that of the normouricemic group (p < 0.001). A multivariate Cox regression model revealed that UA and NT-proBNP were independent predictors of all-cause mortality (HR: 1.105, 95% CI: 1.019-1.198, p = 0.016 and HR: 3.743, CI: 2.647-5.292, p < 0.001, respectively). Patients were divided into 4 groups based on UA (≥ 7 and < 7 mg/dL) and NT-proBNP (≥ 2279 and < 2279 ng/L) levels. All-cause mortality, HF hospitalization, and the composite endpoint of HF hospitalization or all-cause mortality rates were higher in the group with high UA and NT-proBNP levels (p < 0.001, p < 0.001, p < 0.001, respectively). Hyperuricemia alone is an independent predictor of all-cause mortality in chronic HF. However, the combination of UA and NT-proBNP appears to be a stronger predictor of poor outcomes.

The prevalence of both heart failure and vitamin D deficiency increases with age and is associated with poor outcome in the elderly. We aimed to investigate the relationship between all-cause mortality and vitamin D deficiency in elderly patients with chronic heart failure. It is a retrospective, observational cross-sectional study. Median follow-up time was 497 days. 302 patients aged ≥65 years heart failure patients was categorized into tertiles based on the 25-hydroxy-vitamin D levels. Clinical and laboratory parameters were evaluated according to tertiles. Hospitalization rates and overall survival were compared between tertiles. Independent predictors of all cause mortality were defined. Patients with low vitamin D tertile were mostly women (p=0.001), and had a worse NYHA functional class (p=0.005). During follow-up, deaths were more frequent in the first tertile (p = 0.001). All-cause mortality increased significantly with decreasing vitamin D tertiles (from third tertile 7.9%, to 11.9%, to 26%; log rank test p=0.003). No significant difference was observed at the composite endpoint of mortality or HF hospitalizations (P=0.451). Multivariate analysis supported that low vitamin D concentration was an independent predictor of all causes of mortality (HR 0.93; 95% CI 0.89-0.97; p=0.004). Low vitamin D levels were independent predictors of all-cause mortality in the elderly population with chronic heart failure.

All-cause mortality,heart failure,ischemic,non-ischemic,statin

Objective: The main objective of this study is to determine the incidence and predictors of clinical outcomes in patients with AF treated with factor Xa inhibitors in a real‐world setting.Methods: The present study was a multicentre and observational study that included patients with AF who were treated with factor Xa inhibitors. The primary outcome was the composite of ischemic stroke, TIA, systemic embolism, major bleeding, and all‐cause mortality.Results: A total of 1162 patients from 26 cardiology centers were included in this study, with a median age of 72 years. During the median 12‐month follow‐up period, the primary outcome occurred in 195 patients (16.8%). Treatment with rivaroxaban compared with apixaban and edoxaban showed a lower rate of ischemic stroke, TIA, and/or systemic embolism (2.2% vs. 4.7% vs. 6.5%, respectively, p = 0.014). The major bleeding rate was similar between all three factor Xa inhibitors. The all‐cause mortality rate in the rivaroxaban group was lower compared with the apixaban and edoxaban groups (9.8% vs. 15.1% vs. 12.4%, respectively, p = 0.042). Overall, the frequency of primary outcome was 13.8%, 19.6%, and 20.6% for patients treated with rivaroxaban, apixaban, and edoxaban, respectively (p = 0.019). Older age, male sex, low body weight, high bleeding risk, heart failure, hypertension, liver failure, and treatment with apixaban 2.5 mg b.i.d. were independently associated with the development of primary outcome.Conclusion: The follow‐up data from the ANATOLIA‐AF study provides detailed data about the incidence and independent predictors of adverse clinical outcomes in patients with AF treated with factor Xa inhibitor treatment.

Background: The newly described bendopnea in heart failure (HF) is associated with increased cardiac filling pressures. The aim of the study was to show the effect of bendopnea follow-up on reaching optimal medical treatment doses in HF. Methods: A total of 413 patients were screened, and we included 203 patients with HF who were previously evaluated for bendopnea. Demographic data, presence or absence of bendopnea, medical history, laboratory findings, and medical treatments were evaluated. Optimal medical therapy target doses at baseline and 3rd month were compared in groups with and without bendopnea. Results: On admission, 64 patients (31.5%) had bendopnea. The rate of patients with bendopnea decreased in the 3rd month (n=42, 20.7%). The proportion of patients who used at least 50% of the recommended medical treatment dose on admission and in the 3rd month was compared; angiotensin-converting enzyme inhibitor /angiotensin receptor blockers use increased from 40.6% to 71.9% in those with bendopnea (P=0.013), from 56.1% to 81.3% in those without bendopnea (P<0.001) and beta-blockers use increased from 28.2% to 60.9% in those with bendopnea (P=0.042), from 31.6% to 69.8% in those without bendopnea (P<0.001). However, aldosterone antagonists use decreased from 70.3% to 67.2% in those with bendopnea (P=0.961), from 68.4 % to 64.1% in those without bendopnea (P=0.334). Bendopnea was independently effective in achieving ACE-I/ARB target doses (OR: 0.359, CI 95%: 0.151–0.854, P=0.020). Conclusion: Bendopnea follow-up in HF patients can provide a significant improvement in reaching the recommended treatment target doses.

Heart failure (HF) is a progressive clinical syndrome associated with significant morbidity and mortality. It is known that during the course of this syndrome, social factors can impact clinical outcomes alongside medical interventions. Studies have demonstrated that social support provides favorable developments in mortality rates, event-free survival, and readmission rates in HF patients. In our study, we aimed to elucidate the effects of the concept of family, the most significant social support, on clinical characteristics, exercise capacity, echocardiographic, and laboratory features in HF cases. A multicenter cohort study was conducted, including 303 patients previously diagnosed with HF, following current guidelines and presenting for outpatient follow-up. Patients with a new diagnosis of HF, those with acute decompensated HF, and those with a history of malignancy were excluded from the study. Demographic data (age, gender), comorbidities (hypertension, diabetes mellitus, atrial fibrillation, etc.), HF treatments, laboratory tests, and detailed transthoracic echocardiography results were recorded. Patients were divided into two groups based on whether they lived with a spouse, parent, child, or without any of them, defining the presence or absence of family support. In the study, 303 patients with an average age of 62.1±13.0, of which 94 (31%) were female, were included. The mean left ventricular ejection fraction was 28.7±8.1. When the groups were compared in terms of comorbidities, there was no statistically significant difference in the presence of hypertension, diabetes mellitus, hyperlipidemia, chronic obstructive pulmonary disease, stroke, or atrial fibrillation (all p>0.005). Coronary artery disease was more frequently observed in the group with family support, while chronic kidney disease was more common in the group without family support (p=0.008 and p=0.012, respectively). Smoking prevalence was significantly higher in the group without family support, while alcohol use showed no significant difference (p=0.046 and p=0.602, respectively). Analyzing the results, it was observed that patients with family support were more regularly monitored for HF reasons (71% vs. 59%, p=0.054). It has been observed that the social support provided by family members in individuals with HF can have positive effects on the clinical course of the disease and the patient's lifestyle.