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Träfflista för sökning "WFRF:(Hillege Hans L.) srt2:(2005-2009)"

Sökning: WFRF:(Hillege Hans L.) > (2005-2009)

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1.
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2.
  • Jaarsma, Tiny, et al. (författare)
  • Effect of moderate or intensive disease management program on outcome in patients with heart failure : Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH).
  • 2008
  • Ingår i: Archives of Internal Medicine. - : American Medical Association (AMA). - 0003-9926 .- 1538-3679. ; 168:3, s. 316-24
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Heart failure (HF) disease management programs are widely implemented, but data about their effect on outcome have been inconsistent. METHODS: The Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH) was a multicenter, randomized, controlled trial in which 1023 patients were enrolled after hospitalization because of HF. Patients were assigned to 1 of 3 groups: a control group (follow-up by a cardiologist) and 2 intervention groups with additional basic or intensive support by a nurse specializing in management of patients with HF. Patients were studied for 18 months. Primary end points were time to death or rehospitalization because of HF and the number of days lost to death or hospitalization. RESULTS: Mean patient age was 71 years; 38% were women; and 50% of patients had mild HF and 50% had moderate to severe HF. During the study, 411 patients (40%) were readmitted because of HF or died from any cause: 42% in the control group, and 41% and 38% in the basic and intensive support groups, respectively (hazard ratio, 0.96 and 0.93, respectively; P = .73 and P = .52, respectively). The number of days lost to death or hospitalization was 39 960 in the control group, 33 731 days for the basic intervention group (P = .81), and 34 268 for the intensive support group (P = .49). All-cause mortality occurred in 29% of patients in the control group, and there was a trend toward lower mortality in the intervention groups combined (hazard ratio, 0.85; 95% confidence interval, 0.66-1.08; P = .18). There were slightly more hospitalizations in the 2 intervention groups (basic intervention group, P = .89; and intensive support group, P = .60). CONCLUSIONS: Neither moderate nor intensive disease management by a nurse specializing in management of patients with HF reduced the combined end points of death and hospitalization because of HF compared with standard follow-up. There was a nonsignificant, potentially relevant reduction in mortality, accompanied by a slight increase in the number of short hospitalizations in both intervention groups. Clinical Trial Registry http://trialregister.nl Identifier: NCT 98675639.
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3.
  • Damman, Kevin, et al. (författare)
  • Both in- and out-hospital worsening of renal function predict outcome in patients with heart failure : results from the Coordinating Study Evaluating Outcome of Advising and Counseling in Heart Failure (COACH).
  • 2009
  • Ingår i: European Journal of Heart Failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 11:9, s. 847-54
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS: The effect of worsening renal function (WRF) after discharge on outcome in patients with heart failure is unknown. METHODS AND RESULTS: We assessed estimated glomerular filtration rate (eGFR) and serum creatinine at admission, discharge, and 6 and 12 months after discharge, in 1023 heart failure patients. Worsening renal function was defined as an increase in serum creatinine of >26.5 micromol/L and >25%. The primary endpoint was a composite of all-cause mortality and heart failure admissions. The mean age of patients was 71 +/- 11 years, and 62% was male. Mean eGFR at admission was 55 +/- 21 mL/min/1.73 m(2). In-hospital WRF occurred in 11% of patients, while 16 and 9% experienced WRF from 0 to 6, and 6 to 12 months after discharge, respectively. In multivariate landmark analysis, WRF at any point in time was associated with a higher incidence of the primary endpoint: hazard ratio (HR) 1.63 (1.10-2.40), P = 0.014 for in-hospital WRF, HR 2.06 (1.13-3.74), P = 0.018 for WRF between 0-6 months, and HR 5.03 (2.13-11.88), P < 0.001 for WRF between 6-12 months. CONCLUSION: Both in- and out-hospital worsening of renal function are independently related to poor prognosis in patients with heart failure, suggesting that renal function in heart failure patients should be monitored long after discharge.
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4.
  • Hogenhuis, Jochem, et al. (författare)
  • Anaemia and renal dysfunction are independently associated with BNP and NT-proBNP levels in patients with heart failure.
  • 2007
  • Ingår i: European Journal of Heart Failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 9:8, s. 787-94
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Anaemia may affect B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) levels, but this has not been well described in heart failure (HF) patients without the exclusion of patients with renal dysfunction. AIMS: To study the influence of both anaemia and renal function on BNP and NT-proBNP levels in a large group of hospitalised HF patients. METHODS AND RESULTS: We studied 541 patients hospitalised for HF (mean age 71+/-11 years, 62% male, and left ventricular ejection fraction 0.33+/-0.14). Of these patients, 30% (n=159) were anaemic (women: Hb<7.5 mmol/l, men: Hb<8.1 mmol/l). Of the 159 anaemic patients, 73% had renal dysfunction (eGFR<60 ml/min/1.73 m2) and of the non-anaemic patients, 57% had renal dysfunction. BNP and NT-proBNP levels were measured in all patients before discharge. In multivariable analyses both plasma haemoglobin and eGFR were independently related to the levels of BNP and NT-proBNP (standardised beta's of -0.16, -0.14 [BNP] and -0.19, -0.26 [NT-proBNP] respectively, P-values<0.01). CONCLUSION: Anaemia and renal dysfunction are related to increased BNP and NT-proBNP levels, independent of the severity of HF. These results indicate that both anaemia and renal dysfunction should be taken into consideration during the interpretation of BNP and NT-proBNP levels in HF patients.
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5.
  • Hogenhuis, Jochem, et al. (författare)
  • Correlates of B-type natriuretic peptide and 6-min walk in heart failure patients.
  • 2006
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 108:1, s. 63-7
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: B-type natriuretic peptide (BNP) and 6-min walk test (6MWT) are both related to the severity and prognosis in chronic heart failure (CHF), but may reflect different aspects of CHF. We related BNP and 6MWT to left ventricular ejection fraction (LVEF), New York Heart Association functional class (NYHA), and two indices of quality of life (physical subscales): the Minnesota Living with Heart Failure Questionnaire (MLwHFQph) and the RAND-36ph. METHODS: Plasma BNP and 6MWT were measured at discharge in 229 patients who had been admitted for CHF. LVEF and NYHA were determined, and patients completed the MLwHFQ and RAND-36 questionnaires. RESULTS: BNP was weakly correlated to LVEF (r=-0.29, P<0.01) and NYHA (r=0.20, P<0.01), but not to MLwHFQph and RAND-36ph. On the other hand, 6MWT is related to MLwHFQph (r=-0.23, P<0.01), RAND-36ph (r=0.52, P<0.01), and NYHA (r=-0.46, P<0.01), but not to LVEF (r=-0.15, P=0.05). There is also no correlation between BNP and 6MWT (r=-0.01, P=0.87). CONCLUSIONS: The present data show that BNP and 6MWT represent different aspects of the clinical syndrome of CHF. The outcomes of this study suggest that BNP plasma levels are more related to cardiac function, while 6MWT reflects functional capacity and quality of life.
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6.
  • Hogenhuis, Jochem, et al. (författare)
  • Influence of age on natriuretic peptides in patients with chronic heart failure : a comparison between ANP/NT-ANP and BNP/NT-proBNP.
  • 2005
  • Ingår i: European Journal of Heart Failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 7:1, s. 81-86
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Natriuretic peptides are currently used in the diagnosis and follow-up of patients with Chronic Heart Failure (CHF). However, it is unknown whether there are different influences of age on atrial natriuretic peptide (ANP)/N-terminal-ANP (NT-ANP) or B-type natriuretic peptide (BNP)/N-terminal-proBNP (NT-proBNP). AIMS: To compare the influence of age and gender on plasma levels of ANP/NT-ANP and BNP/NT-proBNP in CHF patients. METHODS AND RESULTS: Natriuretic peptides were measured in 311 CHF patients (68+/-8 years, 76% males, left ventricular ejection fraction (LVEF) 0.23+/-0.08). All natriuretic peptides were significantly related to age (p<0.05) on multivariate regression analysis, with partial correlation coefficients of 0.18, 0.29, 0.28 and 0.25 for ANP, NT-ANP, BNP and NT-proBNP, respectively. The relative increase of both BNP/NT-proBNP were more pronounced than of ANP/NT-ANP (p<0.01). Furthermore, the relative increase of BNP with age was markedly larger than of NT-proBNP (p<0.01). Levels of all natriuretic peptides were also significantly related to cardiothoracic ratio, renal function and LVEF. CONCLUSION: In patients with CHF, BNP/NT-proBNP were more related to age than ANP/NT-ANP, and BNP was more related to age than NT-proBNP. However, in these CHF patients the influence of age on the levels of all natriuretic peptides was modest, and comparable to several other factors.
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7.
  • Hogenhuis, Jochem, et al. (författare)
  • Low prevalence of B-type natriuretic peptide levels < 100 pg/mL in patients with heart failure at hospital discharge.
  • 2006
  • Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 151:5, s. 1012.e1-5
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: In patients with acute heart failure (HF) presenting at the emergency department, a B-type natriuretic peptide (BNP) level < 100 pg/mL was found in only 10% of the patients. However, in a more stable outpatient HF population from another study, a BNP level < 100 pg/mL was found in as many as 21% of the patients. Therefore, we aimed to investigate the prevalence and characteristics of stabilized patients with BNP levels < 100 pg/mL before discharge after admission for decompensated heart failure HF. METHODS: We investigated 601 patients with HF who were part of a large-scale multicenter study in The Netherlands. All patients had been admitted for decompensated HF, and their BNP levels were measured before discharge when they had been clinically stabilized. Clinical characteristics of patients with BNP levels < 100 and > or = 100 pg/mL were compared. RESULTS: Patients were 70 +/- 12 years old, 61% were men, and mean left ventricular ejection fraction was 0.34 +/- 0.14. Of these patients, 10% had BNP levels < 100 pg/mL. Patients with a BNP level < 100 pg/mL were similar in age and sex but had higher left ventricular ejection fraction (0.41 +/- 0.14 vs 0.33 +/- 0.13, P < .001), body mass index, and hemoglobin and hematocrit concentrations compared with those with BNP levels > or = 100 pg/mL. CONCLUSIONS: In clinically stable patients with a recent admission for decompensated HF, only 10% had BNP levels > or = 100 pg/mL. These patients with low BNP levels seemed to have less severe HF and more frequently had preserved systolic function compared with patients with BNP levels > or = 100 pg/mL.
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8.
  • Lesman-Leegte, Ivonne, et al. (författare)
  • Depressive symptoms and outcomes in patients with heart failure : data from the COACH study.
  • 2009
  • Ingår i: European Journal of Heart Failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 11:12, s. 1202-7
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS: To study the prognostic value of depressive symptoms on heart failure (HF) readmission and mortality, in a large and clinically relevant population of hospitalized HF patients adjusted for disease severity by B-type natriuretic peptide (BNP) level. METHODS AND RESULTS: We studied 958 patients enrolled after hospitalization for HF; 37% female; mean age 71 +/- 11 years; New York Heart Association class II (51%) or III/IV (49%). Left ventricular ejection fraction: 33% +/- 14%, and median BNP level: 454 pg/mL (75% CI, 195-876 pg/mL). In total, 377 patients (39%) had depressive symptoms [Centre for Epidemiological Studies Depression Scale (CES-D) score >or=16] and 200 (21%) had severe depressive symptoms (score >or=24). During 18 months of follow-up, 386 (40%) patients reached the primary endpoint of death or readmission for HF. In multivariate analyses, CES-D was significantly associated with the primary endpoint [hazard ratio (HR) 1.13, P = 0.02], and also with both individual components of the primary endpoint [HF readmission (HR 1.165, P = 0.02) and mortality (HR 1.169, P = 0.02)]. Patients with severe depressive symptoms had a >40% higher risk for HF readmission or death. CONCLUSION: In patients with HF, depression is independently associated with poor outcomes. These findings highlight the need for continued exploration of whether improvements in depression lead to better cardiovascular outcomes. The study was registered at clinical trial (www.trialregister.nl): NCT 98675639.
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9.
  • Lesman-Leegte, Ivonne, et al. (författare)
  • Determinants of depressive symptoms in hospitalised men and women with heart failure.
  • 2008
  • Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 7:2, s. 121-6
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Depressive symptoms are prominent and related to an increased risk on cardiovascular disease outcomes and all cause mortality in HF patients. AIM: To intervene effectively, factors related to depressive symptoms in men and women should be identified. METHODS: Depressive symptoms of 921 hospitalised HF patients (61% male; age 71+/-11; LVEF 33%+/-14, NYHA II-IV) were assessed by the Center for Epidemiological Studies-Depression scale (CES-D). RESULTS: Overall 40% of the patients had depressive symptoms (CES-D >or=16), which were more common in women than in men (47% versus 36%, p<0.001). Multivariable analysis in men revealed that depressive symptoms were related to age (OR 0.84, 95% CI 0.71-0.98, p=0.03, per 10 years), physical health (OR 0.76, 95% CI 0.71-0.83, p<0.001, per 10 units) and HF symptoms. In women depressive symptoms were also related to NYHA II-III versus IV (OR 0.60, 95% CI 0.37-0.95, p<0.03) and COPD (OR 2.33, 95% CI 1.20-4.53, p<0.012). CONCLUSION: Depressive symptoms are more common in women than in men. In both men and women depressive symptoms are related to age and physical health. For clinical factors: In men only HF symptoms, but in women also NYHA and COPD were related to depressive symptoms.
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10.
  • Lesman-Leegte, Ivonne, et al. (författare)
  • Quality of life and depressive symptoms in the elderly : a comparison between patients with heart failure and age- and gender-matched community controls.
  • 2009
  • Ingår i: Journal of Cardiac Failure. - : Elsevier BV. - 1071-9164 .- 1532-8414. ; 15:1, s. 17-23
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Comparisons of heart failure (HF) patients with an unselected healthy sample in terms of quality of life (QoL) and depressive symptoms might prove misleading. We compared QoL and depressive symptoms of a HF population with an age- and gender-matched sample of community dwelling elderly. METHODS AND RESULTS: Data were collected from 781 HF patients (36% female; age 72 +/- 9; New York Heart Association II-IV) and 781 age- and gender-matched community-dwelling elderly. Participants completed the Medical Outcome Study 36-item General Health Survey, the Cantril's Ladder of life, and the Center for Epidemiological Studies-Depression scale (CES-D). Analysis of variance techniques with Welch F test and chi-square tests were used to describe differences in QoL and depressive symptoms between different groups. For both men and women with HF, QoL was reduced and depressive symptoms were elevated when compared with their elderly counterparts (CES-D >or=16: 39% vs. 21%, P < .001). HF patients had more chronic conditions-specifically diabetes and asthma/chronic obstructive pulmonary disease. Impaired QoL and depressive symptoms were most prevalent among HF patients with comorbidities. Prevalence was also higher in HF patients in the absence of these conditions. CONCLUSIONS: HF has a large impact on QoL and depressive symptoms, especially in women with HF. Differences persist, even in the absence of common comorbidities. Results demonstrate the need for studies of representative HF patients with direct comparisons to age- and gender-matched controls.
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