Relationship of depression to death or hospitalization in patients with heart failure.

Background: Depression is widely recognized as a risk factor in patients with coronary heart disease. However, patients with heart failure (HF) have been less frequently studied, and the effect of depression on prognosis, independent of disease severity, is uncertain.

Methods: Two hundred four outpatients having a diagnosis of HF, with a ventricular ejection fraction of 40% or less, underwent baseline assessments including evaluation of depressive symptoms using the Beck Depression Inventory and of HF severity determined by plasma N-terminal pro-B-type natriuretic peptide.

Prognostic value of anxiety and depression in patients with chronic heart failure.

Background: Anxiety is often present with depression and may be one of its manifestations. Although the adverse effects of depression in patients with chronic heart failure (CHF) have been well studied, the relation between anxiety and CHF prognosis has not been addressed. In a secondary analysis of data collected for a published study of depression and prognosis in patients with CHF, we examined the relations among anxiety, depression, and prognosis.

Effect of angiotensin-converting enzyme inhibitors, beta blockers, statins, and aspirin on C-reactive protein levels in outpatients with heart failure.

C-reactive protein (CRP) levels were measured in a cohort of 96 outpatients with heart failure. Baseline angiotensin-converting enzyme inhibitor plus beta-blocker use were associated with lower levels of CRP; no relation was found between CRP levels and aspirin or statin use.

Implications of elevated cardiac troponin T in ambulatory patients with heart failure: a prospective analysis.

Background: Elevated concentrations of cardiac troponin T (TnT) have been reported in patients hospitalized for decompensated heart failure (HF). We assessed whether elevated TnT levels are associated with the severity, etiology, and prognosis of HF in stable, ambulatory patients.

Methods: From 1998-1999, we prospectively collected data from 136 ambulatory patients with HF, New York Heart Association functional class II to IV, ejection fraction < or =35%, and no recent unstable angina, myocardial infarction, surgery, or coronary revascularization.

Diagnosis and management of heart failure in the long-term care setting.

Heart failure is increasing in incidence and prevalence and is predominantly a condition of the elderly, which confers significant morbidity and mortality risks and places an enormous economic burden on the health care system and society. A reduction in hospitalizations and improvement of quality of life are the primary goals in the management of heart failure. Evidence-based medicine provides clinicians with the best armamentarium to provide high quality and cost-effective care to patients diagnosed with this chronic, progressive, and debilitating condition.

Evaluation of platelets in heart failure: is platelet activity related to etiology, functional class, or clinical outcomes?

Objectives: We sought to determine whether platelet activity in patients with heart failure is related to an ischemic versus nonischemic etiologic condition, clinical disease severity, or adverse clinical outcomes.

Background: Platelet activity may affect outcome in patients with heart failure. A prospective evaluation of the relation of baseline platelet function to etiologic condition, New York Heart Association (NYHA) class, and clinical outcomes has not been previously reported.