The Impact of Cocaine Use and the Obesity Paradox in Patients With Heart Failure With Reduced Ejection Fraction Due to Non-ischemic Cardiomyopathy.
The Impact of Cocaine Use and the Obesity Paradox in Patients With Heart Failure With Reduced Ejection Fraction Due to Non-ischemic Cardiomyopathy.
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可卡因使用和肥胖悖论对心力衰竭患者的影响，由于非缺血性心肌病而导致的射血分数降低。
DOI：
10.7759/cureus.40298
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发表时间：
2023-06
期刊：
影响因子：
--
通讯作者：
Pekler G
中科院分区：
文献类型：
--
作者：
Akinlonu AA;Alonso A;Mene-Afejuku TO;Lopez P;Kansara T;Ola O;Mushiyev S;Pekler G
肥胖和非法药物是发生心力衰竭（HF）的独立危险因素。然而，最近的研究表明，已经患有心衰和肥胖的患者有更好的临床结果。我们的目的是研究可卡因使用对这种肥胖悖论现象的影响，因为它与心衰再入院有关。在回顾性图表分析中，我们回顾了在纽约大都会医院被诊断为心力衰竭并射血分数降低（HFrEF）的患者。我们研究了身体质量指数（BMI）类别，即非肥胖（<30 kg/m2）和肥胖（≥30 kg/m2）、可卡因使用和主要结局（出院后30天内HF再入院时间）之间的关系。还评估了可卡因与肥胖状态之间的相互作用及其与主要结局的关系。结果共鉴定出261例患者。非肥胖状态和可卡因使用与30天内再入院风险增加相关（风险比(HR) = 2.28, p = 0.049和HR = 3.12, p = 0.004）。此外，非肥胖的可卡因使用者在30天内再次入院的可能性是肥胖的非可卡因使用者的6倍以上（HR = 6.45, p = 0.0002）。结论非肥胖状态和持续使用可卡因对心衰再入院有负叠加效应。
Background Obesity and illicit drugs are independent risk factors for developing heart failure (HF). However, recent studies have suggested that patients who already have HF and are obese have better clinical outcomes. We aim to study the effect of cocaine use on this obesity paradox phenomenon as it pertains to HF readmissions. Methodology In a retrospective chart analysis, we reviewed patients with a diagnosis of HF with reduced ejection fraction (HFrEF) admitted to Metropolitan Hospital in New York. We studied the association between body mass index (BMI) categories, namely, non-obese (<30 kg/m2) and obese (≥30 kg/m2), cocaine use, and the primary outcome (time to readmission for HF within 30 days after discharge). The interaction between cocaine and obesity status and its association with the primary outcome was also assessed. Results A total of 261 patients were identified. Non-obese status and cocaine use were associated with an increased hazard of readmission in 30 days (hazard ratio (HR) = 2.28, p = 0.049 and HR = 3.12, p = 0.004, respectively). Furthermore, cocaine users who were non-obese were over six times more likely to be re-admitted in 30 days compared to non-cocaine users who were obese (HR = 6.45, p = 0.0002). Conclusions Non-obese status and continued use of cocaine have a negative additive effect in impacting HF readmissions.
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影响因子：
4.9
作者：
Mandviwala, Taher M.;Basra, Sukhdeep S.;Deswal, Anita
通讯作者：
Deswal, Anita
影响因子：
3.3
作者：
Tanimura, Muneyoshi;Dohi, Kaoru;Ito, Masaaki
通讯作者：
Ito, Masaaki
DOI：
10.1161/hhf.0b013e318291329a
发表时间：
2013-05
期刊：
Circulation. Heart failure
影响因子：
--
作者：
Heidenreich PA;Albert NM;Allen LA;Bluemke DA;Butler J;Fonarow GC;Ikonomidis JS;Khavjou O;Konstam MA;Maddox TM;Nichol G;Pham M;Piña IL;Trogdon JG;American Heart Association Advocacy Coordinating Committee;Council on Arteriosclerosis, Thrombosis and Vascular Biology;Council on Cardiovascular Radiology and Intervention;Council on Clinical Cardiology;Council on Epidemiology and Prevention;Stroke Council
通讯作者：
Stroke Council
影响因子：
4.2
作者：
Cano, Manuel;Oh, Sehun;Vaughn, Michael G.
通讯作者：
Vaughn, Michael G.
影响因子：
37.8
作者：
Anand, Inder S.;Gupta, Pankaj
通讯作者：
Gupta, Pankaj