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Debra K. Moser - One of the best experts on this subject based on the ideXlab platform.
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dietary vitamin c deficiency is associated with health related quality of life and Cardiac Event free survival in adults with heart failure
Journal of Cardiovascular Nursing, 2019Co-Authors: Eun Kyeung Song, Debra K. Moser, Terry A. LennieAbstract:Background Vitamin C deficiency is prevalent in adults with heart failure (HF). Little is known about the relationship of dietary vitamin C deficiency with health outcomes in adults with HF. Objective The study's aim was to determine the relationships of vitamin C deficiency measured at baseline with health-related quality of life (HRQOL) and Cardiac Event-free survival in patients with HF measured 1 year later. Method A total of 251 patients with HF completed a 4-day food diary. Dietary vitamin C deficiency was defined as daily intake less than the estimated average requirement from the Institute of Medicine of 75 mg/d for men and 60 mg/d for women. Health-related quality of life was assessed using the Minnesota Living with Heart Failure Questionnaire at 12 months. Patients were followed for a median of 1 year to determine time to the first Event of Cardiac-related hospitalization or death. Data were analyzed by hierarchical linear and Cox proportional hazards regressions. Results One hundred patients (40%) had vitamin C deficiency. Dietary vitamin C deficiency was associated with poorer HRQOL at 12 months (β = 0.16, P = .02) after controlling for demographic and clinical variables. During the follow-up period, 59 patients (24%) had Cardiac Events. In Cox regression, vitamin C deficiency predicted shorter Cardiac Event-free survival after adjusting for the same covariates (hazards ratio, 1.95; 95% confidence interval, 1.08-3.51). Conclusion Vitamin C deficiency was associated with poorer HRQOL and shorter Cardiac Event-free survival in patients with HF. The findings suggest that encouraging patients with HF to consume a diet rich in fruits/vegetables to prEvent vitamin C deficiency may lead to better health outcomes.
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medication adherence mediates the relationship between heart failure symptoms and Cardiac Event free survival in patients with heart failure
Journal of Cardiovascular Nursing, 2017Co-Authors: Debra K. MoserAbstract:BACKGROUND Heart failure (HF) symptoms such as dyspnea are common and may precipitate hospitalization. Medication nonadherence is presumed to be associated with symptom exacerbations, yet how HF symptoms, medication adherence, and hospitalization/death are related remains unclear. OBJECTIVE The aim of this study was to explore the relationships among HF symptoms, medication adherence, and Cardiac Event-free survival in patients with HF. METHODS At baseline, patient demographics, clinical data, and HF symptoms were collected in 219 patients with HF. Medication adherence was monitored using the Medication Event Monitoring System. Patients were followed for up to 3.5 years to collect hospitalization and survival data. Logistic regression and survival analyses were used for the analyses. RESULTS Patients reporting dyspnea or ankle swelling were more likely to have poor medication adherence (P = .05). Poor medication adherence was associated with worse Cardiac Event-free survival (P = .006). In Cox regression, patients with HF symptoms had 2 times greater risk for a Cardiac Event than patients without HF symptoms (P = .042). Heart failure symptoms were not a significant predictor of Cardiac Event-free survival after entering medication adherence in the model (P = .091), indicating mediation. CONCLUSIONS Medication adherence was associated with fewer HF symptoms and lower rates of hospitalization and death. It is important to develop interventions to improve medication adherence that may reduce HF symptoms and high hospitalization and mortality in patients with HF.
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abstract 12039 health literacy mediates the relationship between perceived control and Cardiac Event free survival in patients with heart failure
Circulation, 2016Co-Authors: Jennifer L Miller, Debra K. MoserAbstract:Introduction: Lower levels of perceived control and health literacy are independently associated with morbidity (higher levels of anxiety and depression or rehospitalizations) in individuals with heart failure (HF). However, little is known about the interrelationship of these two predictors. Low health literacy impairs engagement in the health care process and in doing so may play a role between perceived control and outcomes. Objective: The purpose of this study was to examine the relationships among perceived control, health literacy and Cardiac Event-free survival in patients with HF. Methods: This was a prospective study of 575 rural patients with HF (female 41%, age 66±13, married 57%). Perceived control was assessed using the Control Attitude Scale-Revised. Health literacy was measured by the Short Test of Functional Health Literacy in Adults. Cardiac Events were followed for 24 months by patient/family interview and hospital database review. Linear/logistic regression and survival analyses were used to examine the associations among health literacy, perceived control, and Cardiac Event-free survival. Results: Patients with higher perceived control had higher health literacy. Higher perceived control and higher health literacy were associated with better Cardiac Event-free survival before and after adjusting for covariates (e.g. age, marital status, B-type Natriuretic Peptide) ( p p =.10) after entering health literacy ( p Conclusions: Lower perceived control was associated with worse outcomes and health literacy was a mediator between perceived control and health outcomes. Our results suggest that interventions intended to improve health outcomes in adults with HF need to increase their perceived control of HF care and also take into account patients’ level of health literacy.
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self reported adherence to a low sodium diet and health outcomes in patients with heart failure
Journal of Cardiovascular Nursing, 2016Co-Authors: Eun Kyeung Song, Seokmin Kang, Debra K. Moser, Terry A. LennieAbstract:BACKGROUND: Most clinicians rely on patients' self-report of following a low-sodium diet to determine adherence of patients with heart failure (HF). Whether self-reported adherence to a low-sodium diet is associated with Cardiac Event-free survival is unclear. PURPOSES: To determine (1) whether self-reported is concordant with adherence to a low-sodium diet measured by food diaries and 24-hour urinary sodium excretion and (2) whether self-reported adherence to a low-sodium diet predicts Cardiac Event-free survival. METHODS: Adherence to a low-sodium diet was measured using 3 measures in 119 HF patients: (1) self-reported adherence, 1 item from the Self-care of Heart Failure Index scale; (2) a 3-day food diary; (3) 24-hour urinary sodium excretion. Patients were followed up for a median of 297 days to determine Cardiac hospitalization or emergency department visit. One-way analysis of variance and Cox regression were used to address our purposes. RESULTS: Self-reported adherence was concordant with adherence to a low-sodium diet measured by food diaries and 24-hour urinary sodium excretion. Thirty-one patients who reported they always follow a low-sodium diet had an average sodium intake less than 3 g/d (F = 5.07, P = .002) and 3.3 g of a mean 24-hour urinary sodium excretion (F = 3.393, P = .020). Patients who reported they never or rarely follow a low-sodium diet had 4.7 times greater risk of having Cardiac Events than did those who always followed a low-sodium diet (P = .017). CONCLUSION: Self-reported adherence to a low-sodium diet predicted Cardiac Event-free survival demonstrating clinicians can use this as an indicator of adherence.
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health related quality of life functional status and Cardiac Event free survival in patients with heart failure
Journal of Cardiovascular Nursing, 2016Co-Authors: Terry A. Lennie, Susan K Frazier, Debra K. MoserAbstract:BACKGROUND Health-related quality of life (HRQOL), functional status, and Cardiac Event-free survival are outcomes used to assess the effectiveness of interventions in patients with heart failure (HF). However, the nature of the relationships among HRQOL, functional status, and Cardiac Event-free survival remains unclear. OBJECTIVE The purpose of this study is to examine the nature of the relationships among HRQOL, functional status, and Cardiac Event-free survival in patients with HF. METHODS This was a prospective, observational study of 313 patients with HF that was a secondary analysis from a registry. At baseline, patient demographic and clinical data were collected. Health-related quality of life was assessed using the Minnesota Living With Heart Failure Questionnaire and functional status was measured using the Duke Activity Status Index. Cardiac Event-free survival data were obtained by patient interview, hospital database, and death certificate review. Multiple linear and Cox regressions were used to explore the relationships among HRQOL, functional status, and Cardiac Event-free survival while adjusting for demographic and clinical factors. RESULTS Participants (n = 313) were men (69%), white (79%), and aged 62 ± 11 years. Mean left ventricular ejection fraction was 35% ± 14%. The mean HRQOL score of 32.3 ± 20.6 indicated poor HRQOL. The mean Duke Activity Status Index score of 16.2 ± 12.9 indicated poor functional status. Cardiac Event-free survival was significantly worse in patients who had worse HRQOL or poorer functional status. Patients who had better functional status had better HRQOL (P < .001). Health-related quality of life was not a significant predictor of Cardiac Event-free survival after entering functional status in the model (P = .54), demonstrating that it was a mediator of the relationship between HRQOL and outcome. CONCLUSION Functional status was a mediator between HRQOL and Cardiac Event-free survival. These data suggest that intervention studies to improve functional status are needed.
Terry A. Lennie - One of the best experts on this subject based on the ideXlab platform.
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dietary vitamin c deficiency is associated with health related quality of life and Cardiac Event free survival in adults with heart failure
Journal of Cardiovascular Nursing, 2019Co-Authors: Eun Kyeung Song, Debra K. Moser, Terry A. LennieAbstract:Background Vitamin C deficiency is prevalent in adults with heart failure (HF). Little is known about the relationship of dietary vitamin C deficiency with health outcomes in adults with HF. Objective The study's aim was to determine the relationships of vitamin C deficiency measured at baseline with health-related quality of life (HRQOL) and Cardiac Event-free survival in patients with HF measured 1 year later. Method A total of 251 patients with HF completed a 4-day food diary. Dietary vitamin C deficiency was defined as daily intake less than the estimated average requirement from the Institute of Medicine of 75 mg/d for men and 60 mg/d for women. Health-related quality of life was assessed using the Minnesota Living with Heart Failure Questionnaire at 12 months. Patients were followed for a median of 1 year to determine time to the first Event of Cardiac-related hospitalization or death. Data were analyzed by hierarchical linear and Cox proportional hazards regressions. Results One hundred patients (40%) had vitamin C deficiency. Dietary vitamin C deficiency was associated with poorer HRQOL at 12 months (β = 0.16, P = .02) after controlling for demographic and clinical variables. During the follow-up period, 59 patients (24%) had Cardiac Events. In Cox regression, vitamin C deficiency predicted shorter Cardiac Event-free survival after adjusting for the same covariates (hazards ratio, 1.95; 95% confidence interval, 1.08-3.51). Conclusion Vitamin C deficiency was associated with poorer HRQOL and shorter Cardiac Event-free survival in patients with HF. The findings suggest that encouraging patients with HF to consume a diet rich in fruits/vegetables to prEvent vitamin C deficiency may lead to better health outcomes.
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self reported adherence to a low sodium diet and health outcomes in patients with heart failure
Journal of Cardiovascular Nursing, 2016Co-Authors: Eun Kyeung Song, Seokmin Kang, Debra K. Moser, Terry A. LennieAbstract:BACKGROUND: Most clinicians rely on patients' self-report of following a low-sodium diet to determine adherence of patients with heart failure (HF). Whether self-reported adherence to a low-sodium diet is associated with Cardiac Event-free survival is unclear. PURPOSES: To determine (1) whether self-reported is concordant with adherence to a low-sodium diet measured by food diaries and 24-hour urinary sodium excretion and (2) whether self-reported adherence to a low-sodium diet predicts Cardiac Event-free survival. METHODS: Adherence to a low-sodium diet was measured using 3 measures in 119 HF patients: (1) self-reported adherence, 1 item from the Self-care of Heart Failure Index scale; (2) a 3-day food diary; (3) 24-hour urinary sodium excretion. Patients were followed up for a median of 297 days to determine Cardiac hospitalization or emergency department visit. One-way analysis of variance and Cox regression were used to address our purposes. RESULTS: Self-reported adherence was concordant with adherence to a low-sodium diet measured by food diaries and 24-hour urinary sodium excretion. Thirty-one patients who reported they always follow a low-sodium diet had an average sodium intake less than 3 g/d (F = 5.07, P = .002) and 3.3 g of a mean 24-hour urinary sodium excretion (F = 3.393, P = .020). Patients who reported they never or rarely follow a low-sodium diet had 4.7 times greater risk of having Cardiac Events than did those who always followed a low-sodium diet (P = .017). CONCLUSION: Self-reported adherence to a low-sodium diet predicted Cardiac Event-free survival demonstrating clinicians can use this as an indicator of adherence.
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health related quality of life functional status and Cardiac Event free survival in patients with heart failure
Journal of Cardiovascular Nursing, 2016Co-Authors: Terry A. Lennie, Susan K Frazier, Debra K. MoserAbstract:BACKGROUND Health-related quality of life (HRQOL), functional status, and Cardiac Event-free survival are outcomes used to assess the effectiveness of interventions in patients with heart failure (HF). However, the nature of the relationships among HRQOL, functional status, and Cardiac Event-free survival remains unclear. OBJECTIVE The purpose of this study is to examine the nature of the relationships among HRQOL, functional status, and Cardiac Event-free survival in patients with HF. METHODS This was a prospective, observational study of 313 patients with HF that was a secondary analysis from a registry. At baseline, patient demographic and clinical data were collected. Health-related quality of life was assessed using the Minnesota Living With Heart Failure Questionnaire and functional status was measured using the Duke Activity Status Index. Cardiac Event-free survival data were obtained by patient interview, hospital database, and death certificate review. Multiple linear and Cox regressions were used to explore the relationships among HRQOL, functional status, and Cardiac Event-free survival while adjusting for demographic and clinical factors. RESULTS Participants (n = 313) were men (69%), white (79%), and aged 62 ± 11 years. Mean left ventricular ejection fraction was 35% ± 14%. The mean HRQOL score of 32.3 ± 20.6 indicated poor HRQOL. The mean Duke Activity Status Index score of 16.2 ± 12.9 indicated poor functional status. Cardiac Event-free survival was significantly worse in patients who had worse HRQOL or poorer functional status. Patients who had better functional status had better HRQOL (P < .001). Health-related quality of life was not a significant predictor of Cardiac Event-free survival after entering functional status in the model (P = .54), demonstrating that it was a mediator of the relationship between HRQOL and outcome. CONCLUSION Functional status was a mediator between HRQOL and Cardiac Event-free survival. These data suggest that intervention studies to improve functional status are needed.
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association of depressive symptoms and micronutrient deficiency with Cardiac Event free survival in patients with heart failure
Journal of Cardiac Failure, 2015Co-Authors: Eun Kyeung Song, Seokmin Kang, Debra K. Moser, Terry A. LennieAbstract:Abstract Background Depressive symptoms and malnutrition independently predict Cardiac Events in heart failure (HF) patients. However, the relationships among depressive symptoms, nutritional intake, and Cardiac Event–free survival have not been examined. Methods and Results A total of 232 patients with HF completed the Patient Health Questionnaire 9 (PHQ-9) to measure depressive symptoms and a 3-day food diary to determine the number of micronutrient deficiencies. Patients were followed for 2 years to collect data on Cardiac Event–free survival. Patients were divided into 4 groups by a PHQ-9 score of 10 and the median value of micronutrient deficiencies. Cox regressions were used to determine the relationships among depressive symptoms, micronutrient deficiency, and Cardiac Event–free survival. Depressive symptoms conferred greater risk of Cardiac Events in patients with a high number of micronutrient deficiencies than in those with a low number of micronutrient deficiencies. Patients with a PHQ-9 score ≥10 and number of micronutrient deficiencies >5 had 2.4 times higher risk for Cardiac Events compared with patients with a PHQ-9 score P = .005). Conclusions There was a synergistic effect on the association of depressive symptoms with Cardiac Event–free survival in HF patients that differed by micronutrient deficiency.
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Association of Depressive Symptoms and Micronutrient Deficiency With Cardiac Event–Free Survival in Patients With Heart Failure
Journal of Cardiac Failure, 2015Co-Authors: Eun Kyeung Song, Seokmin Kang, Debra K. Moser, Terry A. LennieAbstract:Abstract Background Depressive symptoms and malnutrition independently predict Cardiac Events in heart failure (HF) patients. However, the relationships among depressive symptoms, nutritional intake, and Cardiac Event–free survival have not been examined. Methods and Results A total of 232 patients with HF completed the Patient Health Questionnaire 9 (PHQ-9) to measure depressive symptoms and a 3-day food diary to determine the number of micronutrient deficiencies. Patients were followed for 2 years to collect data on Cardiac Event–free survival. Patients were divided into 4 groups by a PHQ-9 score of 10 and the median value of micronutrient deficiencies. Cox regressions were used to determine the relationships among depressive symptoms, micronutrient deficiency, and Cardiac Event–free survival. Depressive symptoms conferred greater risk of Cardiac Events in patients with a high number of micronutrient deficiencies than in those with a low number of micronutrient deficiencies. Patients with a PHQ-9 score ≥10 and number of micronutrient deficiencies >5 had 2.4 times higher risk for Cardiac Events compared with patients with a PHQ-9 score P = .005). Conclusions There was a synergistic effect on the association of depressive symptoms with Cardiac Event–free survival in HF patients that differed by micronutrient deficiency.
Diana L Kunze - One of the best experts on this subject based on the ideXlab platform.
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variability of the qtc interval impact on defining drug effect and low frequency Cardiac Event
American Journal of Cardiology, 1993Co-Authors: Joel Morganroth, Arthur M Brown, Stuart Critz, William J Crumb, Diana L KunzeAbstract:Abstract Prolongation of the QT interval corrected for heart rate (QT c ) can lead to the development of torsades de pointes, a life-threatening form of polymorphic ventricular tachycardia. However, the QT c interval duration exhibits a high degree of spontaneous variability and is not necessarily a direct predictor of the risk of torsades. This observation holds implications for the assessment of the potential proarrhythmic effects of nonCardiac pharmacologic agents. To date, the antihistamine terfenadine is the only nonCardiac drug that has undergone a comprehensive and systematic evaluation related to the consequences of its causing QT c prolongation. The results suggest that QT c prolongation resulting solely from terfenadine at clinical doses does not have an important impact on clinically relevant endpoints. The risk of serious ventricular arrhythmias with terfenadine using epidemiologic data is the same or less than that associated with traditional first-generation antihistamines. The risk of a clinical Cardiac Event (QT c prolongation, ventricular arrhythmias, syncope, or sudden death) with terfenadine is similar to that of other antihistamines. Factors associated with increased risk in patients taking terfenadine include significant liver disease, hypokalemia, overdose, and concomitant administration of ketoconazole-like agents or erythromycin; use of terfenadine is relatively contraindicated in these settings. No increased risk of serious arrhythmias has been confirmed in conjunction wtth the use of terfenadine in patients with Cardiac disease.
Eun Kyeung Song - One of the best experts on this subject based on the ideXlab platform.
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dietary vitamin c deficiency is associated with health related quality of life and Cardiac Event free survival in adults with heart failure
Journal of Cardiovascular Nursing, 2019Co-Authors: Eun Kyeung Song, Debra K. Moser, Terry A. LennieAbstract:Background Vitamin C deficiency is prevalent in adults with heart failure (HF). Little is known about the relationship of dietary vitamin C deficiency with health outcomes in adults with HF. Objective The study's aim was to determine the relationships of vitamin C deficiency measured at baseline with health-related quality of life (HRQOL) and Cardiac Event-free survival in patients with HF measured 1 year later. Method A total of 251 patients with HF completed a 4-day food diary. Dietary vitamin C deficiency was defined as daily intake less than the estimated average requirement from the Institute of Medicine of 75 mg/d for men and 60 mg/d for women. Health-related quality of life was assessed using the Minnesota Living with Heart Failure Questionnaire at 12 months. Patients were followed for a median of 1 year to determine time to the first Event of Cardiac-related hospitalization or death. Data were analyzed by hierarchical linear and Cox proportional hazards regressions. Results One hundred patients (40%) had vitamin C deficiency. Dietary vitamin C deficiency was associated with poorer HRQOL at 12 months (β = 0.16, P = .02) after controlling for demographic and clinical variables. During the follow-up period, 59 patients (24%) had Cardiac Events. In Cox regression, vitamin C deficiency predicted shorter Cardiac Event-free survival after adjusting for the same covariates (hazards ratio, 1.95; 95% confidence interval, 1.08-3.51). Conclusion Vitamin C deficiency was associated with poorer HRQOL and shorter Cardiac Event-free survival in patients with HF. The findings suggest that encouraging patients with HF to consume a diet rich in fruits/vegetables to prEvent vitamin C deficiency may lead to better health outcomes.
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self reported adherence to a low sodium diet and health outcomes in patients with heart failure
Journal of Cardiovascular Nursing, 2016Co-Authors: Eun Kyeung Song, Seokmin Kang, Debra K. Moser, Terry A. LennieAbstract:BACKGROUND: Most clinicians rely on patients' self-report of following a low-sodium diet to determine adherence of patients with heart failure (HF). Whether self-reported adherence to a low-sodium diet is associated with Cardiac Event-free survival is unclear. PURPOSES: To determine (1) whether self-reported is concordant with adherence to a low-sodium diet measured by food diaries and 24-hour urinary sodium excretion and (2) whether self-reported adherence to a low-sodium diet predicts Cardiac Event-free survival. METHODS: Adherence to a low-sodium diet was measured using 3 measures in 119 HF patients: (1) self-reported adherence, 1 item from the Self-care of Heart Failure Index scale; (2) a 3-day food diary; (3) 24-hour urinary sodium excretion. Patients were followed up for a median of 297 days to determine Cardiac hospitalization or emergency department visit. One-way analysis of variance and Cox regression were used to address our purposes. RESULTS: Self-reported adherence was concordant with adherence to a low-sodium diet measured by food diaries and 24-hour urinary sodium excretion. Thirty-one patients who reported they always follow a low-sodium diet had an average sodium intake less than 3 g/d (F = 5.07, P = .002) and 3.3 g of a mean 24-hour urinary sodium excretion (F = 3.393, P = .020). Patients who reported they never or rarely follow a low-sodium diet had 4.7 times greater risk of having Cardiac Events than did those who always followed a low-sodium diet (P = .017). CONCLUSION: Self-reported adherence to a low-sodium diet predicted Cardiac Event-free survival demonstrating clinicians can use this as an indicator of adherence.
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association of depressive symptoms and micronutrient deficiency with Cardiac Event free survival in patients with heart failure
Journal of Cardiac Failure, 2015Co-Authors: Eun Kyeung Song, Seokmin Kang, Debra K. Moser, Terry A. LennieAbstract:Abstract Background Depressive symptoms and malnutrition independently predict Cardiac Events in heart failure (HF) patients. However, the relationships among depressive symptoms, nutritional intake, and Cardiac Event–free survival have not been examined. Methods and Results A total of 232 patients with HF completed the Patient Health Questionnaire 9 (PHQ-9) to measure depressive symptoms and a 3-day food diary to determine the number of micronutrient deficiencies. Patients were followed for 2 years to collect data on Cardiac Event–free survival. Patients were divided into 4 groups by a PHQ-9 score of 10 and the median value of micronutrient deficiencies. Cox regressions were used to determine the relationships among depressive symptoms, micronutrient deficiency, and Cardiac Event–free survival. Depressive symptoms conferred greater risk of Cardiac Events in patients with a high number of micronutrient deficiencies than in those with a low number of micronutrient deficiencies. Patients with a PHQ-9 score ≥10 and number of micronutrient deficiencies >5 had 2.4 times higher risk for Cardiac Events compared with patients with a PHQ-9 score P = .005). Conclusions There was a synergistic effect on the association of depressive symptoms with Cardiac Event–free survival in HF patients that differed by micronutrient deficiency.
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Association of Depressive Symptoms and Micronutrient Deficiency With Cardiac Event–Free Survival in Patients With Heart Failure
Journal of Cardiac Failure, 2015Co-Authors: Eun Kyeung Song, Seokmin Kang, Debra K. Moser, Terry A. LennieAbstract:Abstract Background Depressive symptoms and malnutrition independently predict Cardiac Events in heart failure (HF) patients. However, the relationships among depressive symptoms, nutritional intake, and Cardiac Event–free survival have not been examined. Methods and Results A total of 232 patients with HF completed the Patient Health Questionnaire 9 (PHQ-9) to measure depressive symptoms and a 3-day food diary to determine the number of micronutrient deficiencies. Patients were followed for 2 years to collect data on Cardiac Event–free survival. Patients were divided into 4 groups by a PHQ-9 score of 10 and the median value of micronutrient deficiencies. Cox regressions were used to determine the relationships among depressive symptoms, micronutrient deficiency, and Cardiac Event–free survival. Depressive symptoms conferred greater risk of Cardiac Events in patients with a high number of micronutrient deficiencies than in those with a low number of micronutrient deficiencies. Patients with a PHQ-9 score ≥10 and number of micronutrient deficiencies >5 had 2.4 times higher risk for Cardiac Events compared with patients with a PHQ-9 score P = .005). Conclusions There was a synergistic effect on the association of depressive symptoms with Cardiac Event–free survival in HF patients that differed by micronutrient deficiency.
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higher dietary lycopene intake is associated with longer Cardiac Event free survival in patients with heart failure
European Journal of Cardiovascular Nursing, 2013Co-Authors: Martha J. Biddle, Eun Kyeung Song, Debra K. Moser, Seongkum Heo, Heather Payneemerson, Sandra B Dunbar, Susan J Pressler, Terry A. LennieAbstract:Background:The antioxidant lycopene may be beneficial for patients with heart failure (HF). Processed tomato products are a major source of lycopene, although they are also high in sodium. Increased sodium intake may counter the positive antioxidant effect of lycopene.Methods:This was a prospective study of 212 patients with HF. Dietary intake of lycopene and sodium was obtained from weighted 4-day food diaries. Patients were grouped by the median split of lycopene of 2471 µg/day and stratified by daily sodium levels above and below 3 g/day. Patients were followed for 1 year to collect survival and hospitalization data. Cox proportional hazards modeling was used to compare Cardiac Event-free survival between lycopene groups within each stratum of sodium intake.Results:Higher lycopene intake was associated with longer Cardiac Event-free survival compared with lower lycopene intake (p = 0.003). The worst Cardiac Event-free survival was observed in the low lycopene intake group regardless of sodium intake (>...
Lewis B Morgenstern - One of the best experts on this subject based on the ideXlab platform.
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recurrent stroke risk is higher than Cardiac Event risk after initial stroke transient ischemic attack
Stroke, 2005Co-Authors: Devin L Brown, Lynda D Lisabeth, Canopy Roychoudhury, Lewis B MorgensternAbstract:Background and Purpose— Patients with ischemic stroke and transient ischemic attack (TIA) are at risk for recurrent cerebrovascular and Cardiac Events. Understanding which of these adverse Events is more likely to occur next is instructive for prEventive therapy planning. Methods— Subjects (n=1923) were identified from a sample of hospital discharges from administrative claims for the Michigan Medicare population from January 2001 to June 2001 using International Classification of Diseases, 9th Revision codes for ischemic stroke/TIA. Outcomes (Cardiac Events, myocardial infarction [MI], percutaneous transluminal coronary angioplasty [PTCA], coronary artery bypass grafting [CABG] and ischemic strokes) were identified for 2001 to 2003. Comparison between Cardiac and stroke as secondary Events were made using cumulative incidence estimates. Results— Over the follow-up period, 172 patients had a Cardiac Event (62.8% MI, 7.6% CABG, 14.5% PTCA, 9.3% MI and PTCA, and 5.8% MI and CABG) and 239 had a stroke as the...