Heart

Zhuang, Sheng; Huang, Shue; Huang, Zhe; Zhang, Shun; Al-Shaar, Laila; Chen, Shuohua; Wu, Shouling; Gao, Xiang

doi: 10.1136/heartjnl-2022-321799pmid: 36593101

ObjectiveTo investigate whether nighttime sleep duration and snoring status were associated with incident heart failure (HF).MethodsA prospective study was conducted based on Kailuan cohort including 93 613 adults free of pre-existing cardiovascular diseases. Sleep duration and snoring status were assessed by self-reported questionnaire. Incident HF cases were ascertained by medical records. Cox proportional hazards model was applied to calculate the HR and 95% CI of risk of developing HF. Mediation analysis was used to understand whether hypertension and diabetes mediated the association between sleep duration, snoring and HF. Data analysis was performed from 1 June 2021 to 1 June 2022.ResultsDuring a median follow-up of 8.8 years, we documented 1343 incident HF cases. Relative to sleep duration of 7.0–7.9 hour/night, short sleep duration was associated with higher risk of developing HF: adjusted HR was 1.24 (95% CI 1.01 to 1.55) for <6 hours/night and 1.29 (95% CI 1.06 to 1.57) for 6.0–6.9 hours/night, after adjustment for potential confounders such as age, sex, smoking, hypertension and diabetes. A similar 20%–30% higher risk of incident HF was found in individuals reporting occasional or frequent snoring relative to never/rare snorers: adjusted HR was 1.32 for occasional snoring (95% CI 1.14 to 1.52) and 1.24 (95% CI 1.06 to 1.46) for frequent snoring. Presence of diabetes significantly mediated the association between both short sleep duration and snoring and HF risk and hypertension significantly mediated the snoring–HF relationship.ConclusionShort sleep duration and snoring were associated with high risk of HF.

Linz, Dominik; Schnabel, Renate B

doi: 10.1136/heartjnl-2022-321806pmid: 36593096

Luciani, Marco; Müller, Daniel; Vanetta, Chiara; Diteepeng, Thamonwan; von Eckardstein, Arnold; Aeschbacher, Stefanie; Rodondi, Nicolas; Moschovitis, Giorgio; Reichlin, Tobias; Sinnecker, Tim; Wuerfel, Jens; Bonati, Leo H; Saeedi Saravi, Seyed Soheil; Chocano-Bedoya, Patricia;

Nguyen, Dan D; Arnold, Suzanne V

doi: 10.1136/heartjnl-2022-321631pmid: 36604164

Frailty is a syndrome of older age that reflects an impaired physiological reserve and decreased ability to recover from medical stressors. While the impact of frailty on mortality in cardiovascular disease has been well described, its impact on cardiovascular disease–specific health status—cardiac symptoms, physical functioning and quality of life—has been less well studied. In this review, we summarise the impact of frailty on health status outcomes across different cardiovascular conditions. In heart failure, frail patients have markedly impaired disease-specific health status and are at risk for subsequent health status deteriorations. However, frail patients have similar or even greater health status improvements with interventions for heart failure, such as cardiac rehabilitation or guideline-directed medical therapy. In valvular heart disease, the impact of frailty on disease-specific health status is of even greater concern since management involves physiologically taxing procedures that can worsen health status. Frailty increases the risk of poor health status outcomes after transcatheter aortic valve intervention or surgical aortic valve replacement for aortic stenosis, but there is no evidence that frail patients benefit more from one procedure versus another. In both heart failure and valvular heart disease, health status improvements may reverse frailty, highlighting the overlap between cardiovascular disease and frailty and emphasising that treatment should typically not be withheld based on the presence of frailty alone. Meanwhile, data are limited on the impact of frailty on health status outcomes in the treatment of coronary artery disease, peripheral artery disease and atrial fibrillation, and requires further research.

Marateb, Hamid Reza; Mansourian, Marjan; Mañanas, Miguel Angel

doi: 10.1136/heartjnl-2022-322246pmid: 36639230

Thompson, David R; Pedersen, Susanne S

doi: 10.1136/heartjnl-2022-321607pmid: 36593099

Yu, Xinming; Botezatu, Simona; Tzolos, Evangelos; Dey, Damini; Kwiecinski, Jacek

doi: 10.1136/heartjnl-2022-321158pmid: 36627185

Cuthbertson, Carmen C; Moore, Christopher C; Evenson, Kelly R

doi: 10.1136/heartjnl-2022-321856pmid: 36593098

Abdulsalam, Nashwa M; Poole, Jeanne E

doi: 10.1136/heartjnl-2022-322092pmid: 36593095

Morishita, Tetsuji; Takada, Daisuke; Shin, Jung-ho; Kunisawa, Susumu; Fushimi, Kiyohide; Imanaka, Yuichi

doi: 10.1136/heartjnl-2022-321695pmid: 36627183

ObjectiveEstablishing appropriate percutaneous coronary intervention (PCI) in stable angina pectoris (SAP) has become a distinctive performance measure worldwide. Clinical guidelines call for documenting ischaemia in patients with SAP prior to elective PCI. The Japanese Ministry of Health, Labour and Welfare introduced a new reimbursement policy in April 2018 to promote the appropriate and judicious implementation of PCI. The 2018 reimbursement changes clarified the required proof of ischaemia. Tests to evaluate functional ischaemia and coronary stenosis have been added as a requirement for reimbursement. We examined whether this reimbursement revision had an impact on PCI procedures for SAP in Japan.MethodsWe used administrative claims data in Japan’s Diagnosis Procedure Combination database from April 2014 through March 2020. We used interrupted time series analyses with a control to ascertain the impacts on elective PCI procedures before and after the Japanese reimbursement revision. The primary outcome was the change in elective PCI procedures per month. Emergent PCI procedures served as a control group.ResultsA total of 773 240 PCI procedures were identified between April 2014 and March 2020: 388 817 and 180 462 elective PCIs before and after the reimbursement revision, respectively. After the 2018 reimbursement revision, significant trend changes were found in elective PCI procedures per month (−106.3, 95% CI −155.8 to −56.8, p<0.01), while the number of emergent PCIs remained stable throughout the study period.ConclusionsAfter revising the reimbursement tariff for elective PCIs in 2018, there was a significant reduction in elective PCI procedures per month.