RESUMEN
OBJECTIVE: To identify the relationship between red blood cell distribution width (RDW, %), interleukin-6 (IL-6) (pg/ml), high sensitivity-c-reactive protein (hs-CRP) (mg/l), in-hospital mortality and disease severity among patients with heart failure (HF). METHODS: Prospective cohort. We included adults diagnosed with acute non-ischemic HF in 2015. The dependent variables were in-hospital mortality (yes or no) and disease severity. The latter was assessed with the Get With The Guidelines-HF score. We used hierarchical regression models to describe the pattern of association between biomarkers, mortality, and severity. We used the Youden index to identify the best cut-off for mortality prediction. RESULTS: We included 167 patients; the mean age was 72.61 (SD: 11.06). The majority of patients presented with New York Heart Association classification II (40.12%) or III (43.11%). After adjusting for age and gender, all biomarkers were associated with mortality. After adding comorbidities, only IL-6 was associated. The final model with all clinical variables showed no effect from any biomarker. The best cut-off for RDW, hs-CRP and IL-6 for mortality were 14.8, 68.7 and 52.9, respectively. IL-6 presented the highest sensitivity (100%), specificity (75.35%) and area under the curve (0.91). CONCLUSIONS: No biomarker is independent from the most important clinical variables; therefore it should not be used for management modifications.
RESUMEN
Objectives: The purpose of this article was to determine the change in the volume of pacemaker implantations with the COVID-2019 pandemic and to assess the change in the number of pacemaker implants according to etiology during the pandemic. Background: The establishment of a mandatory social isolation have generated a decrease in activities in cardiology units. Methods: Descriptive, cross-sectional study that used a database of a Peruvian Hospital. Time was divided into three categories: Before COVID period and COVID period including Previous to Social isolation (SI) and Social Isolation. The number of pacemaker implantations were compared per the same amount of time. Results: A reduction in the pacemaker implant of 73% (95% CI: 33-113; P < .001) was observed during the COVID-19 pandemic period, and a reduction of 78% of patients with the diagnosis of complete or high-grade atrioventricular block and a reduction in the de-novo pacemaker implant was observed, regardless of the etiology. Conclusions: Our results indicate a very significant reduction (73%) in de-novo pacemaker implantation during the months of the COVID-19 pandemic. The reduction in the number of de-novo pacemaker occurred independent of the etiology.
