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BACKGROUND: Hyperuricemia is associated with a poorer prognosis in heart failure (HF) patients. Benefits of hyperuricemia treatment with allopurinol have not yet been confirmed in clinical practice. The aim of our work was to assess the benefit of allopurinol treatment in a large cohort of HF patients. METHODS: The prospective acute heart failure registry (AHEAD) was used to select 3160 hospitalized patients with a known level of uric acid (UA) who were discharged in a stable condition. Hyperuricemia was defined as UA ≥500 μmoL/L and/or allopurinol treatment at admission. The patients were classified into three groups: without hyperuricemia, with treated hyperuricemia, and with untreated hyperuricemia at discharge. Two- and five-year all-cause mortality were defined as endpoints. Patients without hyperuricemia, unlike those with hyperuricemia, had a higher left ventricular ejection fraction, a better renal function, and higher hemoglobin levels, had less frequently diabetes mellitus and atrial fibrillation, and showed better tolerance to treatment with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and/or beta-blockers. RESULTS: In a primary analysis, the patients without hyperuricemia had the highest survival rate. After using the propensity score to set up comparable groups, the patients without hyperuricemia had a similar 5-year survival rate as those with untreated hyperuricemia (42.0% vs 39.7%, P = 0.362) whereas those with treated hyperuricemia had a poorer prognosis (32.4% survival rate, P = 0.006 vs non-hyperuricemia group and P = 0.073 vs untreated group). CONCLUSION: Hyperuricemia was associated with an unfavorable cardiovascular risk profile in HF patients. Treatment with low doses of allopurinol did not improve the prognosis of HF patients.

MeSH
akutní nemoc MeSH
alopurinol aplikace a dávkování MeSH
antiuratika aplikace a dávkování MeSH
biologické markery krev MeSH
časové faktory MeSH
hyperurikemie krev komplikace farmakoterapie MeSH
kyselina močová krev MeSH
lidé středního věku MeSH
lidé MeSH
míra přežití trendy MeSH
následné studie MeSH
příčina smrti MeSH
prognóza MeSH
prospektivní studie MeSH
registrace * MeSH
senioři nad 80 let MeSH
senioři MeSH
srdeční selhání komplikace mortalita MeSH
tendenční skóre * MeSH
výsledek terapie MeSH
vztah mezi dávkou a účinkem léčiva MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
senioři nad 80 let MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
multicentrická studie MeSH
Geografické názvy
Česká republika MeSH

Článek

AHEAD score--Long-term risk classification in acute heart failure

International journal of cardiology. 2016 ; 202 (-) : 21-6. [pub] 20150828

Int J Cardiol
ISSN 1874-1754
Medvik
Zdroj

BACKGROUND: The role of co-morbidities in the prognosis of patients hospitalized for AHF was examined using the AHEAD (A--atrial fibrillation, H--haemoglobin<130 g/l for men and 120 g/l for women (anaemia), E--elderly (age>70years), A--abnormal renal parameters (creatinine>130 μmol/l), D--diabetes mellitus) scoring system. METHODS: AHEAD--multicentre prospective Czech registry of AHF patients; GREAT registry--international cohort of AHF patients. Data from 5846 consecutive patients hospitalized for AHF (AHEAD registry; derivation cohort) were analysed to build the AHEAD score. Each risk factor of the AHEAD score was counted as 1 point. The model was validated externally using an international cohort of similar patients in the GREAT registry (6315). RESULTS: Main outcome was one year all-cause mortality. The mean age of patients was 72±12 years, with 61.6% of patients aged >70 years; 43.4% were women. Atrial fibrillation was present in 30.7%, anaemia in 38.2%, creatinine>130 mmol/l (abnormal renal parameters) in 30.1%, and diabetes mellitus in 44.0%. The mean AHEAD score was 2.1. In patients with AHEAD scores of 0-5, the one-year mortality rates were 13.6%, 23.4%, 32.0%, 41.1%, 47.7%, and 58.2%, respectively (p<0.001), and the 90 month mortality rates were 35.1%, 57.3%, 73.5%, 84.8%, 88.0%, and 91.7%, respectively (p<0.001). CONCLUSION: The AHEAD is a simple scoring system based on the analysis of co-morbidities for the estimation of the short and long term prognosis of patients hospitalized for AHF.

MeSH
akutní nemoc MeSH
časové faktory MeSH
hodnocení rizik metody MeSH
incidence MeSH
lidé MeSH
míra přežití trendy MeSH
mortalita v nemocnicích trendy MeSH
následné studie MeSH
prediktivní hodnota testů MeSH
příčina smrti trendy MeSH
prognóza MeSH
prospektivní studie MeSH
registrace * MeSH
reprodukovatelnost výsledků MeSH
rizikové faktory MeSH
senioři MeSH
srdeční katetrizace MeSH
srdeční selhání klasifikace diagnóza epidemiologie MeSH
Check Tag
lidé MeSH
mužské pohlaví MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
multicentrická studie MeSH
práce podpořená grantem MeSH
Geografické názvy
Česká republika MeSH

Článek

Co by internista neměl na EKG přehlédnout
[What an internal medicine specialist should not overlook in EKG records]

Čihalík, Čestmír, 1949-
Autor Autorita LF UP v Olomouci, FN Olomouc, I. interní klinika - kardiologická

Postgraduální medicína. 2015 ; 17 (Příloha 2) : 31-38. (Interna)

Postgraduální med.
ISSN 1212-4184
Medvik
Zdroj

Interna. 2015 ; 17 (Příloha 2) : 31-38.

ISSN 1212-4184
Medvik
Zdroj

Abstrakt

Tak dlouho se chodí se džbánem pro vodu, až se ucho utrhne

Pediatrie pro praxi. 2015 ; 16 (Suppl. A) : A12-A13. (Kongres pediatrů a dětských sester, XXXII. dny praktické a nemocniční pediatrie, Olomouc, 15.-16. května 2015)

ISSN 1213-0494
Medvik
Zdroj

Pediatrie pro praxi - kongres pediatrů a dětských sester. 2015 ; () : A12-A13.

ISSN 1803-5892
Medvik
Zdroj

Publikační typ
abstrakt z konference MeSH

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