Journal of Personalized Medicine

Research

12 pages, 1083 KiB

Open AccessArticle

The Role of the Cumulative Illness Rating Scale (CIRS) in Estimating the Impact of Comorbidities on Chronic Obstructive Pulmonary Disease (COPD) Outcomes: A Pilot Study of the MACH (Multidimensional Approach for COPD and High Complexity) Study

by Domenico Di Raimondo, Edoardo Pirera, Chiara Pintus, Riccardo De Rosa, Martina Profita, Gaia Musiari, Gherardo Siscaro and Antonino Tuttolomondo

J. Pers. Med. 2023, 13(12), 1674; https://doi.org/10.3390/jpm13121674 - 30 Nov 2023

Viewed by 1138

Abstract

Background. Chronic obstructive pulmonary disease (COPD) is a heterogeneous systemic syndrome that often coexists with multiple comorbidities. In highly complex COPD patients, the role of the Cumulative Illness Rating Scale (CIRS) as a risk predictor of COPD exacerbation is not known. Objective. The [...] Read more.

Background. Chronic obstructive pulmonary disease (COPD) is a heterogeneous systemic syndrome that often coexists with multiple comorbidities. In highly complex COPD patients, the role of the Cumulative Illness Rating Scale (CIRS) as a risk predictor of COPD exacerbation is not known. Objective. The objective of this study was determine the effectiveness of the CIRS score in detecting the association of comorbidities and disease severity with the risk of acute exacerbations in COPD patients. Methods. In total, 105 adults with COPD (mean age 72.1 ± 9.0 years) were included in this prospective study. All participants at baseline had at least two moderate exacerbations or one leading to hospitalization. The primary outcome was a composite of moderate or severe COPD exacerbation during the 12 months of follow-up. Results. The CIRS indices (CIRS total score, Severity Index and Comorbidity Index) showed a positive correlation with modified Medical Research Council (mMRC), COPD assessment test (CAT) and a negative correlation with forced expiratory volume in the first second (FEV₁), Forced Vital Capacity (FVC), and FEV₁/FVC. The three CIRS indices were able to predict the 12-month rate of moderate or severe exacerbation (CIRS Total Score: Hazard Ratio (HR) = 1.12 (95% CI: 1.08–1.21); CIRS Severity Index: HR = 1.21 (95% CI: 1.12–1.31); CIRS Comorbidity Index = 1.58 (95% CI: 1.33–1.89)). Conclusions. Among patients with COPD, the comorbidity number and severity, as assessed by the CIRS score, influence the risk in moderate-to-severe exacerbations. The CIRS score also correlates with the severity of respiratory symptoms and lung function. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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18 pages, 965 KiB

Open AccessArticle

Effectiveness of Mindfulness and Positive Strengthening mHealth Interventions for the Promotion of Subjective Emotional Wellbeing and Management of Self-Efficacy for Chronic Cardiac Diseases

by Carmen Tabernero, Tamara Gutiérrez-Domingo, Patrizia Steca, Rosario Castillo-Mayén, Esther Cuadrado, Sebastián J. Rubio, Naima Z. Farhane-Medina and Bárbara Luque

J. Pers. Med. 2022, 12(12), 1953; https://doi.org/10.3390/jpm12121953 - 25 Nov 2022

Viewed by 1775

Abstract

Intervention in health prevention and treatment via mobile phones is becoming a key element on health promotion. Testing the efficacy of these mobile health (mHealth) psychological interventions for cardiovascular health is necessary as it is a chronic pathology, and it can influence the [...] Read more.

Intervention in health prevention and treatment via mobile phones is becoming a key element on health promotion. Testing the efficacy of these mobile health (mHealth) psychological interventions for cardiovascular health is necessary as it is a chronic pathology, and it can influence the affective and cognitive states of patients. This research aimed to analyze the effectiveness of two brief psychological interventions—mindfulness and positive strengthening—to promote subjective emotional wellbeing and disease management self-efficacy using mHealth. This was a three-arm intervention and feasibility study, with a pre-post design and three follow-up measures with 105 patients (93 completed all phases) with cardiovascular diseases. Group 1 and 2 received the mindfulness or strengthening intervention, and Group 3 was the control group. The positive–negative affect and management self-efficacy for chronic and cardiovascular diseases were analyzed over time, while anxiety and depression levels were assessed at the beginning of the study. The results showed that mindfulness and positive strengthening interventions both had a positive effect on participants’ affective state and management self-efficacy for the disease in comparison with the control group over time, even after controlling for baseline anxiety and depression levels. Positive strengthening seems to be more effective for improving cardiac self-efficacy, while mindfulness practice was significantly more effective at reducing negative affect at the first face-to-face evaluation. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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12 pages, 1000 KiB

Open AccessArticle

Prognostic Nutritional Index and Major Cardiovascular Events in Patients Undergoing Invasive Coronary Angiography: A Clinical Retrospective Study

by Xiang Hu, Kanru Sang, Chen Chen, Liyou Lian, Kaijing Wang, Yaozhang Zhang, Xuedong Wang, Qi Zhou, Huihui Deng and Bo Yang

J. Pers. Med. 2022, 12(10), 1679; https://doi.org/10.3390/jpm12101679 - 09 Oct 2022

Cited by 2 | Viewed by 1229

Abstract

We aimed to examine whether prognostic nutritional index (PNI) could serve as an auxiliary predictor for major cardiovascular events (MCEs) in patients undergoing invasive coronary angiography (ICA). A total of 485 participants were enrolled, divided into low-PNI (≥47.40) and high-PNI (<47.40) groups. ICA [...] Read more.

We aimed to examine whether prognostic nutritional index (PNI) could serve as an auxiliary predictor for major cardiovascular events (MCEs) in patients undergoing invasive coronary angiography (ICA). A total of 485 participants were enrolled, divided into low-PNI (≥47.40) and high-PNI (<47.40) groups. ICA determined the stenotic vessels of coronary artery disease. The primary outcome was incidental MCEs, a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, or rehospitalization of in-stent restenosis. There were 47 (9.69%) MCEs during the 3.78-years follow-up. The cumulative incidence of MCEs was significantly higher in the low-PNI patients compared with the high-PNI patients (17.07% vs. 7.18%, p = 0.001). Malnutrition risk (low PNI) was significantly and independently associated with a higher risk of MCEs (hazard ratios: 2.593, 95% confidence intervals [CI]: 1.418–4.742). Combined use of the number of stenotic vessels with malnutrition risk showed a higher capacity to predict the MCEs than the presence of stenotic vessels alone (areas under the receiver operator characteristic curve: 0.696 [95% CI, 0.618–0.775] vs. 0.550 [95% CI, 0.466–0.633], p = 0.013). In conclusion, lower PNI levels may predict a higher risk of cardiovascular events in patients undergoing ICA, which supports the necessity of the risk assessment of nutrition status and guide the clinical treatment on strengthening nutritional support before ICA is performed, as well as nutritional intervention after ICA. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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12 pages, 780 KiB

Open AccessArticle

Hypnotics Use Is Associated with Elevated Incident Atrial Fibrillation: A Propensity-Score Matched Analysis of Cohort Study

by Xiang Hu, Gwo-Ping Jong, Liang Wang, Mei-Chen Lin, Shao-Qing Gong, Xue-Hong Zhang, Jiun-Jie Lin, Esther Adeniran, Yan-Long Liu, Hung-Yi Chen and Bo Yang

J. Pers. Med. 2022, 12(10), 1645; https://doi.org/10.3390/jpm12101645 - 04 Oct 2022

Cited by 2 | Viewed by 2984

Abstract

We aimed to investigate the association between either or both of benzodiazepines (BZDs) and non-BZDs and the incidence of atrial fibrillation (AF) in the Taiwan National Health Insurance Database. The participants with at least two prescriptions of BZDs and/or non-BZDs were identified as [...] Read more.

We aimed to investigate the association between either or both of benzodiazepines (BZDs) and non-BZDs and the incidence of atrial fibrillation (AF) in the Taiwan National Health Insurance Database. The participants with at least two prescriptions of BZDs and/or non-BZDs were identified as hypnotics users, whereas those without any prescription of hypnotics were non-hypnotics users. The hypnotics and non-hypnotics cohorts were 1:1 matched on their propensity scores. A total of 109,704 AF-free individuals were included; 610 AF cases occurred in the 54,852 hypnotics users and 166 in the 54,852 non-hypnotics users during the 602,470 person-years of follow-up, with a higher risk of new-onset AF in the users than the non-users (hazard ratio (HR): 3.61, 95% confidence interval [CI]: 3.04–4.28). The users at the highest tertiles of the estimated defined daily doses per one year (DDD) had a greater risk for AF than the non-users, with the risk increasing by 7.13-fold (95% CI: 5.86–8.67) for >0.74-DDD BZDs, 10.68-fold (95% CI: 6.13–18.62) for >4.72-DDD non-BZDs, and 3.26-fold (95% CI: 2.38–4.47) for > 1.65-DDD combinations of BZDs with non-BZDs, respectively. In conclusion, hypnotics use was associated with elevated incidence of AF in the Taiwanese population, which highlighted that the high-dose usage of hypnotics needs more caution in clinical cardiological practice. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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11 pages, 803 KiB

Open AccessArticle

Risk of Ischemic Heart Disease Associated with Primary Dysmenorrhea: A Population-Based Retrospective Cohort Study

by Chung-Hsin Yeh, Chih-Hsin Muo, Fung-Chang Sung and Pao-Sheng Yen

J. Pers. Med. 2022, 12(10), 1610; https://doi.org/10.3390/jpm12101610 - 29 Sep 2022

Cited by 3 | Viewed by 1714

Abstract

The awareness on ischemic heart disease (IHD) in women with dysmenorrhea is insufficient. We utilized the National Health Insurance Research Database (NHIRD) of Taiwan to evaluate this relationship. From the claims data, we established a cohort of women aged 15–50 years with primary [...] Read more.

The awareness on ischemic heart disease (IHD) in women with dysmenorrhea is insufficient. We utilized the National Health Insurance Research Database (NHIRD) of Taiwan to evaluate this relationship. From the claims data, we established a cohort of women aged 15–50 years with primary dysmenorrhea diagnosed from 2000 to 2008 (n = 18,455) and a comparison cohort (n = 36,910) without dysmenorrhea, frequency matched by age and diagnosis date. Both cohorts were followed until the end of 2013 to assess IHD events. With 75% of study population aged 15–29 years, the incidence of IHD was greater in the dysmenorrheal cohort than in the comparison cohort (1.93 versus 1.18 per 10,000 person-years), with an adjusted hazard ratio of 1.60 (95% confidence interval [CI] = 1.38–1.85). The incidence increased with age and the rate of increase was greater in the dysmenorrheal cohort than the comparison cohort. Nested case-control analysis in the dysmenorrhea cohort showed that IHD risk was also associated with hypertension and arrhythmia, with adjusted odds ratios of 2.50 (95% CI = 1.64–3.81) and 3.30 (95% CI = 2.25–4.86), respectively. Women with dysmenorrhea are at a higher risk of developing IHD, particularly for older patients and patients with comorbidity. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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9 pages, 229 KiB

Open AccessArticle

Association of Blood Pressure Indices with Right and Left Cardio-Ankle Vascular Index (CAVI) and Its Mathematically Corrected Form (CAVI₀) for the Evaluation of Atherosclerosis

by Tzu-Jen Hung, Nan-Chen Hsieh, Elaheh Alizargar, Chyi-Huey Bai, Kai-Wei K. Wang, Shahrokh Hatefi and Javad Alizargar

J. Pers. Med. 2022, 12(9), 1386; https://doi.org/10.3390/jpm12091386 - 26 Aug 2022

Cited by 1 | Viewed by 1608

Abstract

Background and Objectives: The cardio-ankle vascular index (CAVI) is an index for arterial stiffness that is theoretically independent of blood pressure. CAVI₀ is the mathematically corrected formula of CAVI that has been claimed to be less dependent on blood pressure changes. The [...] Read more.

Background and Objectives: The cardio-ankle vascular index (CAVI) is an index for arterial stiffness that is theoretically independent of blood pressure. CAVI₀ is the mathematically corrected formula of CAVI that has been claimed to be less dependent on blood pressure changes. The association of right and left CAVI and CAVI₀ with blood pressure indices can reveal the importance of considering the blood pressure of the patient despite their theoretical independency. In this study, we assessed the right and left CAVI and CAVI₀ and evaluated the main effect of blood pressure indices on them with respect to age. Materials and Methods: We collected the following data of 136 community-dwelling individuals: age; sex; weight; height; body mass index; right and left CAVI and CAVI₀; and systolic (SBP), diastolic (DBP), and mean blood pressure (MBP). The association of right and left CAVI and CAVI₀ with blood pressure indices was evaluated using regression analysis. Results: Regression analysis revealed that SBP, DBP, and MBP were associated with right and left CAVI (independent of age). Moreover, SBP was associated with both right and left CAVI₀ (independent of age), whereas DBP was not associated with right or left CAVI₀. Conclusion: Right and left arterial stiffness measured using CAVI has no different associations with SBP, DBP, and MBP. Both right and left CAVI₀ were independently associated with SBP, whereas neither left nor right CAVI₀ was independently associated with DBP. MBP was only associated with the right-side CAVI₀ in community-dwelling individuals. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

13 pages, 872 KiB

Open AccessArticle

Ability of the LACE Index to Predict 30-Day Readmissions in Patients with Acute Myocardial Infarction

by Vasuki Rajaguru, Tae Hyun Kim, Jaeyong Shin, Sang Gyu Lee and Whiejong Han

J. Pers. Med. 2022, 12(7), 1085; https://doi.org/10.3390/jpm12071085 - 30 Jun 2022

Cited by 2 | Viewed by 1378

Abstract

Aims: This study aimed to utilize the existing LACE index (length of stay, acuity of admission, comorbidity index and emergency room visit in the past six months) to predict the risk of 30-day readmission and to find the associated factors in patients with [...] Read more.

Aims: This study aimed to utilize the existing LACE index (length of stay, acuity of admission, comorbidity index and emergency room visit in the past six months) to predict the risk of 30-day readmission and to find the associated factors in patients with AMI. Methods: This was a retrospective study and LACE index scores were calculated for patients admitted with AMI between 2015 and 2019. Data were utilized from the hospital’s electronic medical record. Multivariate logistic regression was performed to find the association between covariates and 30-day readmission. The risk prediction ability of the LACE index for 30-day readmission was analyzed by receiver operating characteristic curves with the C statistic. Results: A total of 205 (5.7%) patients were readmitted within 30 days. The odds ratio of older age group (OR = 1.78, 95% CI: 1.54–2.05), admission via emergency ward (OR = 1.45; 95% CI: 1.42–1.54) and LACE score ≥10 (OR = 2.71; 95% CI: 1.03–4.37) were highly associated with 30-day readmissions and statistically significant. The receiver operating characteristic curve C statistic of the LACE index for AMI patients was 0.78 (95% CI: 0.75–0.80) and showed favorable discrimination in the prediction of 30-day readmission. Conclusion: The LACE index showed a good discrimination to predict the risk of 30-day readmission for hospitalized patients with AMI. Further study would be recommended to focus on additional factors that can be used to predict the risk of 30-day readmission; this should be considered to improve the model performance of the LACE index for other acute conditions by using the national-based administrative data. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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11 pages, 2564 KiB

Open AccessFeature PaperArticle

Cardiac Allograft Rejection Induces Changes in Nucleocytoplasmic Transport: RANGAP1 as a Potential Non-Invasive Biomarker

by Silvia Lozano-Edo, Esther Roselló-Lletí, Ignacio Sánchez-Lázaro, Estefanía Tarazón, Manuel Portolés, Maryem Ezzitouny, Raquel Lopez-Vilella, Miguel Angel Arnau, Luis Almenar and Luis Martínez-Dolz

J. Pers. Med. 2022, 12(6), 913; https://doi.org/10.3390/jpm12060913 - 31 May 2022

Viewed by 1467

Abstract

The non-invasive diagnosis of acute cellular rejection (ACR) is a major challenge. We performed a molecular study analyzing the predictive capacity of serum RanGTPase AP1 (RANGAP1) for diagnosing ACR during the first year after heart transplantation (HT). We included the serum samples of [...] Read more.

The non-invasive diagnosis of acute cellular rejection (ACR) is a major challenge. We performed a molecular study analyzing the predictive capacity of serum RanGTPase AP1 (RANGAP1) for diagnosing ACR during the first year after heart transplantation (HT). We included the serum samples of 75 consecutive HT patients, extracted after clinical stability, to determine the RANGAP1 levels through ELISA. In addition, various clinical, analytical, and echocardiographic variables, as well as endomyocardial biopsy results, were collected. RANGAP1 levels were higher in patients who developed ACR (median 63.15 ng/mL; (inter-quartile range (IQR), 36.61–105.69) vs. 35.33 ng/mL (IQR, 19.18–64.59); p = 0.02). Receiver operating characteristic (ROC) curve analysis confirmed that RANGAP1 differentiated between patients with and without ACR (area under curve (AUC), 0.70; p = 0.02), and a RANGAP1 level exceeding the cut-off point (≥90 ng/mL) was identified as a risk factor for the development of ACR (OR, 6.8; p = 0.006). Two independent predictors of ACR identified in this study were higher RANGAP1 and N-terminal pro-brain natriuretic peptide levels. The analysis of the ROC curve of the model showed a significant AUC of 0.77, p = 0.001. Our findings suggest that RANGAP1 quantification facilitates risk prediction for the occurrence of ACR and could be considered as a novel non-invasive biomarker of ACR. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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8 pages, 643 KiB

Open AccessFeature PaperArticle

Out-of-Sample Validity of the PROLOGUE Score to Predict Neurologic Function after Cardiac Arrest

by Christoph Schriefl, Christian Schoergenhofer, Nina Buchtele, Matthias Mueller, Michael Poppe, Christian Clodi, Florian Ettl, Anne Merrelaar, Magdalena Sophie Boegl, Philipp Steininger, Michael Holzer, Harald Herkner and Michael Schwameis

J. Pers. Med. 2022, 12(6), 876; https://doi.org/10.3390/jpm12060876 - 26 May 2022

Cited by 3 | Viewed by 1307

Abstract

Background: The clinical value of a prognostic score depends on its out-of-sample validity because inaccurate outcome prediction can be not only useless but potentially fatal. We aimed to evaluate the out-of-sample validity of a recently developed and highly accurate Korean prognostic score for [...] Read more.

Background: The clinical value of a prognostic score depends on its out-of-sample validity because inaccurate outcome prediction can be not only useless but potentially fatal. We aimed to evaluate the out-of-sample validity of a recently developed and highly accurate Korean prognostic score for predicting neurologic outcome after cardiac arrest in an independent, plausibly related sample of European cardiac arrest survivors. Methods: Analysis of data from a European cardiac arrest center, certified in compliance with the specifications of the German Council for Resuscitation. The study sample included adults with nontraumatic out-of-hospital cardiac arrest admitted between 2013 and 2018. Exposure was the PROgnostication using LOGistic regression model for Unselected adult cardiac arrest patients in the Early stages (PROLOGUE) score, including 12 clinical variables readily available at hospital admission. The outcome was poor 30-day neurologic function, as assessed using the cerebral performance category scale. The risk of a poor outcome was calculated using the PROLOGUE score regression equation. Predicted risk deciles were compared to observed outcome estimates in a complete-case analysis, a best-case analysis, and a multiple-data-imputation analysis using the Markov chain Monte Carlo method. Results: A total of 1051 patients (median 61 years, IQR 50–71; 29% female) were analyzed. A total of 808 patients (77%) were included in the complete-case analysis. The PROLOGUE score overestimated the risk of poor neurologic outcomes in the range of 40% to 100% predicted risk, involving 63% of patients. The model fit did not improve after missing data imputation. Conclusions: In a plausibly related sample of European cardiac arrest survivors, risk prediction by the PROLOGUE score was largely too pessimistic and failed to replicate the high accuracy found in the original study. Using the PROLOGUE score as an example, this study highlights the compelling need for independent validation of a proposed prognostic score to prevent potentially fatal mispredictions. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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9 pages, 758 KiB

Open AccessArticle

Exposure to Proton Pump Inhibitors and the Risk of Incident Asthma in Patients with Coronary Artery Diseases: A Population-Based Cohort Study

by Tsung-Kun Lin, Chin-Feng Tsai, Jing-Yang Huang, Lung-Fa Pan and Gwo-Ping Jong

J. Pers. Med. 2022, 12(5), 824; https://doi.org/10.3390/jpm12050824 - 19 May 2022

Cited by 2 | Viewed by 1650

Abstract

We aimed to determine the association between proton pump inhibitor (PPI) use and incident asthma in patients with coronary artery disease (CAD). This nationwide cohort study collected claims data from the Taiwanese Bureau of National Health Insurance from 2004 to 2013. The primary [...] Read more.

We aimed to determine the association between proton pump inhibitor (PPI) use and incident asthma in patients with coronary artery disease (CAD). This nationwide cohort study collected claims data from the Taiwanese Bureau of National Health Insurance from 2004 to 2013. The primary outcome, i.e., the risk of incident asthma, was assessed by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). The adjusted HR of asthma development was estimated using the Cox regression model. Sensitivity and subgroup analyses were also conducted. A total of 8894 PPI users and 12,684 H2-receptor antagonist (H2RA) users were included in patients with CAD. Compared with H2RA use, an increased risk of incident asthma was found between PPI use and the risk of incident asthma in patients with CAD after adjusting for sex, age, urbanization, and low income (HR: 1.41; 95% CI: 1.04–1.89). The sensitivity analysis results were consistent with the main analysis results. However, the subgroup analysis revealed no association of incident asthma in patients with diabetes mellitus, hyperlipidemia, stroke, allergic rhinitis, pneumonia, cancer, or depression in the PPI group compared with those in the H2RA group. In conclusion, PPI use increased the risk of asthma development in patients with CAD. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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11 pages, 1452 KiB

Open AccessArticle

Statins Associated with Better Long-Term Outcomes in Aged Hospitalized Patients with COPD: A Real-World Experience from Pay-for-Performance Program

by Ying-Yi Chen, Tsai-Chung Li, Chia-Ing Li, Shih-Pin Lin and Pin-Kuei Fu

J. Pers. Med. 2022, 12(2), 299; https://doi.org/10.3390/jpm12020299 - 17 Feb 2022

Cited by 2 | Viewed by 1729

Abstract

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally. Previous studies have addressed the impact of comorbidity on short-term mortality in patients with COPD. However, the prevalence of cardiovascular disease (CVD) and the association of statins prescription with mortality [...] Read more.

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally. Previous studies have addressed the impact of comorbidity on short-term mortality in patients with COPD. However, the prevalence of cardiovascular disease (CVD) and the association of statins prescription with mortality for aged COPD patients remains unclear. We enrolled 296 aged, hospitalized patients who were monitored in the pay-for-performance (P-4-P) program of COPD. Factors associated with long-term mortality were identified by Cox regression analysis. The median age of the study cohort was 80 years old, and the prevalence of coronary artery disease (CAD) and statins prescriptions were 16.6% and 31.4%, respectively. The mortality rate of the median 3-year follow-up was 51.4%. Through multivariate analysis, body mass index (BMI), statin prescription, and events of respiratory failure were associated with long-term mortality. A Cox analysis showed that statins prescription was associated with lower mortality (hazard ratio (HR): 0.5, 95% Confident interval, 95% CI: 0.34–0.73, p = 0.0004) and subgroup analysis showed that rosuvastatin prescription had protective effect on long-term mortality (HR: 0.44; 95% CI: 0.20–0.97; p < 0.05). Statin prescriptions might be associated with better long-term survival in aged COPD patients, especially those who experienced an acute exacerbation of COPD (AECOPD) who require hospitalization. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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Review

Jump to: Research, Other

13 pages, 307 KiB

Open AccessReview

Biosensors for the Rapid Detection of Cardiovascular Biomarkers of Vital Interest: Needs, Analysis and Perspectives

by Laure Abensur Vuillaume, Justine Frija-Masson, Meriem Hadjiat, Thomas Riquier, Marie-Pia d’Ortho, Pierrick Le Borgne, Christophe Goetz, Paul L. Voss, Abdallah Ougazzaden, Jean-Paul Salvestrini and Thierry Leïchlé

J. Pers. Med. 2022, 12(12), 1942; https://doi.org/10.3390/jpm12121942 - 22 Nov 2022

Cited by 4 | Viewed by 1869

Abstract

We have previously surveyed a panel of 508 physicians from around the world about which biomarkers would be relevant if obtained in a very short time frame, corresponding to emergency situations (life-threatening or not). The biomarkers that emerged from this study were markers [...] Read more.

We have previously surveyed a panel of 508 physicians from around the world about which biomarkers would be relevant if obtained in a very short time frame, corresponding to emergency situations (life-threatening or not). The biomarkers that emerged from this study were markers of cardiovascular disease: troponin, D-dimers, and brain natriuretic peptide (BNP). Cardiovascular disease is a group of disorders affecting the heart and blood vessels. At the intersection of medicine, basic research and engineering, biosensors that address the need for rapid biological analysis could find a place of choice in the hospital or primary care ecosystem. Rapid, reliable, and inexpensive analysis with a multi-marker approach, including machine learning analysis for patient risk analysis, could meet the demand of medical teams. The objective of this opinion review, proposed by a multidisciplinary team of experts (physicians, biologists, market access experts, and engineers), is to present cases where a rapid biological response is indeed valuable, to provide a short overview of current biosensor technologies for cardiac biomarkers designed for a short result time, and to discuss existing market access issues. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

9 pages, 1303 KiB

Open AccessReview

Impact of Glucocorticoids on Cardiovascular System—The Yin Yang Effect

by Chase Kelley, Jonathan Vander Molen, Jennifer Choi, Sahar Bhai, Katelyn Martin, Cole Cochran and Prasanth Puthanveetil

J. Pers. Med. 2022, 12(11), 1829; https://doi.org/10.3390/jpm12111829 - 03 Nov 2022

Cited by 2 | Viewed by 2062

Abstract

Glucocorticoids are not only endogenous hormones but are also administered exogenously as an anti-inflammatory and immunosuppressant for their long-term beneficial and lifesaving effects. Because of their potent anti-inflammatory property and ability to curb the cytokines, they are administered as lifesaving steroids. This property [...] Read more.

Glucocorticoids are not only endogenous hormones but are also administered exogenously as an anti-inflammatory and immunosuppressant for their long-term beneficial and lifesaving effects. Because of their potent anti-inflammatory property and ability to curb the cytokines, they are administered as lifesaving steroids. This property is not only made use of in the cardiovascular system but also in other major organ systems and networks. There is a fine line between their use as a protective anti-inflammatory and a steroid that could cause overuse-induced complications in major organ systems including the cardiovascular system. Studies conducted in the cardiovascular system demonstrate that glucocorticoids are required for growth and development and also for offering protection against inflammatory signals. Excess or long-term glucocorticoid administration could alter cardiac metabolism and health. The endogenous dysregulated state due to excess endogenous glucocorticoid release from the adrenals as seen with Cushing’s syndrome or excess exogenous glucocorticoid administration leading to Cushing’s-like condition show a similar impact on the cardiovascular system. This review highlights the importance of maintaining a glucocorticoid balance whether it is endogenous and exogenous in regulating cardiovascular health. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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10 pages, 1017 KiB

Open AccessReview

Diabetes Mellitus and Heart Failure

by Wun-Zhih Siao, Yong-Hsin Chen, Chin-Feng Tsai, Chun-Ming Lee and Gwo-Ping Jong

J. Pers. Med. 2022, 12(10), 1698; https://doi.org/10.3390/jpm12101698 - 11 Oct 2022

Cited by 5 | Viewed by 2946

Abstract

The coexistence of diabetes mellitus (DM) and heart failure (HF) is frequent and is associated with a higher risk of hospitalization for HF and all-cause and cardiovascular mortality. It has been estimated that millions of people are affected by HF and DM, and [...] Read more.

The coexistence of diabetes mellitus (DM) and heart failure (HF) is frequent and is associated with a higher risk of hospitalization for HF and all-cause and cardiovascular mortality. It has been estimated that millions of people are affected by HF and DM, and the prevalence of both conditions has increased over time. Concomitant HF and diabetes confer a worse prognosis than each alone; therefore, managing DM care is critical for preventing HF. This article reviews the prevalence of HF and diabetes and the correlated prognosis as well as provides a basic understanding of diabetic cardiomyopathy, including its pathophysiology, focusing on the relationship between DM and HF with a preserved ejection fraction and summarizes the potential aldosterone and the mineralocorticoid receptor antagonists approaches for managing heart failure and DM. Sodium–glucose cotransporter 2 inhibitors (SGLT2Is) are an emerging class of glucose-lowering drugs, and the role of SGLT2Is in DM patients with HF was reviewed to establish updated and comprehensive concepts for improving optimal medical care in clinical practice. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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Other

Jump to: Research, Review

6 pages, 1952 KiB

Open AccessCase Report

Case Report: A Rare Manifestation of Pulmonary Arterial Hypertension in Ankylosing Spondylitis

by Tsung-Yuan Yang, Yong-Hsin Chen, Wun-Zhih Siao and Gwo-Ping Jong

J. Pers. Med. 2023, 13(1), 62; https://doi.org/10.3390/jpm13010062 - 28 Dec 2022

Cited by 2 | Viewed by 1505

Abstract

Ankylosing spondylitis (AS) is an inflammatory disease that involves the axial skeleton and can present with extra-articular manifestations. However, there are scarce reports describing the link between AS and pulmonary arterial hypertension (PAH). Herein, we report on a 58-year-old man with a history [...] Read more.

Ankylosing spondylitis (AS) is an inflammatory disease that involves the axial skeleton and can present with extra-articular manifestations. However, there are scarce reports describing the link between AS and pulmonary arterial hypertension (PAH). Herein, we report on a 58-year-old man with a history of AS for 32 years who developed PAH as confirmed by echocardiography and right cardiac catheterization. To our knowledge, this is the first case of AS associated with PAH 32 years after the AS diagnosis with a detailed clinical description. We are recommended that physicians should be aware of this rare comorbidity in AS patients. Early echocardiographic screening is necessary for symptomatic patients. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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Open AccessSystematic Review

LACE Index to Predict the High Risk of 30-Day Readmission: A Systematic Review and Meta-Analysis

by Vasuki Rajaguru, Whiejong Han, Tae Hyun Kim, Jaeyong Shin and Sang Gyu Lee

J. Pers. Med. 2022, 12(4), 545; https://doi.org/10.3390/jpm12040545 - 30 Mar 2022

Cited by 7 | Viewed by 3147

Abstract

The LACE index accounts for: Length of stay (L), Acuity of admission (A), Comorbidities (C), and recent Emergency department use (E). This study aimed to explore the LACE index to predict the high risk of 30-day readmission in patients with diverse disease conditions [...] Read more.

The LACE index accounts for: Length of stay (L), Acuity of admission (A), Comorbidities (C), and recent Emergency department use (E). This study aimed to explore the LACE index to predict the high risk of 30-day readmission in patients with diverse disease conditions by an updated systematic review. A systematic review carried out by electronic databases from 2011–2021. The studies included a LACE index score for 30-day of readmission and patients with all types of diseases and were published in the English language. The meta-analysis was performed by using a random-effects model with a 95% confidence interval. Of 3300 records, a total of 16 studies met the inclusion criteria. The country of publication was primarily the USA (n = 7) and study designs were retrospective and perspective cohorts. The average mean age was 64 years. The C-statistics was 0.55 to 0.81. The pooled random effects of relative risk readmission were overall (RR, 0.20; 95% CI, 0.12–0.34) and it was favorable. The subgroup analysis of the opted disease-based relative risk of readmissions of all causes, cardiovascular and pulmonary diseases, and neurological diseases were consistent and statistically significant at p < 0.001 level. Current evidence of this review suggested that incorporating a high-risk LACE index showed favorable to risk prediction and could be applied to predict 30-day readmission with chronic conditions. Future study would be planned to predict the high risk of 30-day readmission in acute clinical care for utility, and applicability of promising LACE index in South Korean hospitals. Full article

(This article belongs to the Special Issue Personalized Medicine in Cardiovascular Diseases)

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