Nevertheless, the best treatment remains prevention.”
“Background: Our aim was to examine the health resource utilization and cost of care associated with heart failure (HF) and diabetes mellitus (DM) for elderly Medicare enrollees
Methods and Results: A retrospective case-control design was used to identify 4 groups of elderly patients with HF and
DM (n = 498). HF only (n = 1089, DM only (n = 971), and no-HF and no-DM (n = 5438) using an administrative database of a large urban academic health care system Demographic, diagnostic, health resource utilization, and cost (reimbursement) data were obtained from the Medicare claims database for the years 2000 and 2001 Disease
states were identified by ICD-9 codes Costs and health resource utilization were compared across the groups The mean Quizartinib clinical trial total costs were highest for the group with HF and DM ($32.676). and second highest for the HF only group ($22,230). In multivariable models that adjusted for potentially influential emanates. the group with I IF and DM had a 3-fold increase in total cost compared with the group without DM and HF (relative total cost = 451.95% confidence interval 3.82-5.31).
Conclusions: The presence of DM has a selleck kinase inhibitor substantial influence on the costs for managing older patients with HF An integrated approach to management may be needed (J Cardiac Fail 2010.16 454-460)”
“Background: The aim of the present study was to assess the influence of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) use on the incidence of contrast-induced nephropathy (CIN) in patients AC220 order undergoing coronary angiography.
Methods:
A retrospective case control study was conducted on a total of 201 patients divided into 2 groups (CIN group and control group). CIN was defined as an increase in serum creatinine by more than 25% from baseline within 48 hours of radiocontrast exposure. The CIN group had 96 patients, and the control group had 105 patients. The 2 groups were matched for variables such as age, sex, weight, baseline serum creatinine, diabetes, dye load, use of diuretics, statins and preprocedure prophylactic measures for CIN.
Results: The incidence of CIN was found to be 4.55%. The CIN group had 96 patients out of which 56 patients (58.3%) were on chronic ACEI or ARB, while the control group had 105 patients, but only 36 of patients (34.3%) were on ACEI or ARB (p<0.001). The odds ratio for development of CIN with respect to ACEI or ARB use was 2.68 (95% confidence interval, 1.51-4.76).
Conclusion: Use of ACEI or ARB is an independent risk factor for developing CIN. It is reasonable to discontinue their use 48 hours prior to exposure to radiocontrast agents, especially in patients with multiple risk factors.