Reducing Heart Failure Hospitalizations Through Enhancement Of Multidisciplinary Roles And Targeted Patient Oversight
HFSA ePoster Library. Filyo L. 09/10/21; 343627; 7
Lisa Filyo
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Abstract
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Introduction: Patients with a history of heart failure (HF) are at greater risk of worse clinical outcomes in the setting of COVID-19. Cardiac biomarkers provide insight regarding injury, volume status, and structural abnormalities which predispose to hospitalization. Cardiac bridging integrator 1 (cBIN1) is a membrane deformation protein associated with cardiomyocyte t-tubules and has prognostic value in stable ambulatory patients with HF. Novel biomarkers may identify patients at high risk for re-hospitalization after COVID-19.
Methods: We performed a single-centered prospective cohort study of patients who were hospitalized with COVID-19 from September 2020 through April 2021. Blood serum specimens from enrolled patients were collected upon hospital admission, weekly and upon discharge for quantification of troponin T, B-natriuretic peptide (BNP) and, cBIN1. Demographics, medical histories and outcomes were captured from the hospitals’ electronic health records. New or worsening HF was defined as any new left ventricular systolic dysfunction, decrease in ejection fraction >5% or a decompensated state in the setting of a prior history of HF.
Results: A total of 41 patients were enrolled, of which 12 presented with new or worsening HF during their index admission. Of these, 4 patients were re-hospitalized within 30 days of discharge, all of which had a prior history of HF. Two had presented with acute hypoxic respiratory failure (AHRF), one with acute renal injury and one with a rectus sheath hematoma. In those readmitted, none had presented primarily with an acutely worsening HF state, however presenting BNP values were elevated and cBIN1 scores trended lower (1.5 ± 0.65 vs 2.6 ± 0.63, p = 0.04) as compared to those who were not readmitted.
Conclusion: Patients admitted with COVID-19 who experience HF syndrome have elevated BNP and are high risk to be readmitted. Those with low cBIN1 scores and elevated BNP remain at risk for re-hospitalization, but likely not for primary cardiovascular complications. In patients hospitalized with COVID-19, cBIN1 score provides insight regarding intrinsic health of cardiac muscle which is independent of natriuretic peptides, a reflection of volume overload or acute decompensation.
Methods: We performed a single-centered prospective cohort study of patients who were hospitalized with COVID-19 from September 2020 through April 2021. Blood serum specimens from enrolled patients were collected upon hospital admission, weekly and upon discharge for quantification of troponin T, B-natriuretic peptide (BNP) and, cBIN1. Demographics, medical histories and outcomes were captured from the hospitals’ electronic health records. New or worsening HF was defined as any new left ventricular systolic dysfunction, decrease in ejection fraction >5% or a decompensated state in the setting of a prior history of HF.
Results: A total of 41 patients were enrolled, of which 12 presented with new or worsening HF during their index admission. Of these, 4 patients were re-hospitalized within 30 days of discharge, all of which had a prior history of HF. Two had presented with acute hypoxic respiratory failure (AHRF), one with acute renal injury and one with a rectus sheath hematoma. In those readmitted, none had presented primarily with an acutely worsening HF state, however presenting BNP values were elevated and cBIN1 scores trended lower (1.5 ± 0.65 vs 2.6 ± 0.63, p = 0.04) as compared to those who were not readmitted.
Conclusion: Patients admitted with COVID-19 who experience HF syndrome have elevated BNP and are high risk to be readmitted. Those with low cBIN1 scores and elevated BNP remain at risk for re-hospitalization, but likely not for primary cardiovascular complications. In patients hospitalized with COVID-19, cBIN1 score provides insight regarding intrinsic health of cardiac muscle which is independent of natriuretic peptides, a reflection of volume overload or acute decompensation.
Introduction: Patients with a history of heart failure (HF) are at greater risk of worse clinical outcomes in the setting of COVID-19. Cardiac biomarkers provide insight regarding injury, volume status, and structural abnormalities which predispose to hospitalization. Cardiac bridging integrator 1 (cBIN1) is a membrane deformation protein associated with cardiomyocyte t-tubules and has prognostic value in stable ambulatory patients with HF. Novel biomarkers may identify patients at high risk for re-hospitalization after COVID-19.
Methods: We performed a single-centered prospective cohort study of patients who were hospitalized with COVID-19 from September 2020 through April 2021. Blood serum specimens from enrolled patients were collected upon hospital admission, weekly and upon discharge for quantification of troponin T, B-natriuretic peptide (BNP) and, cBIN1. Demographics, medical histories and outcomes were captured from the hospitals’ electronic health records. New or worsening HF was defined as any new left ventricular systolic dysfunction, decrease in ejection fraction >5% or a decompensated state in the setting of a prior history of HF.
Results: A total of 41 patients were enrolled, of which 12 presented with new or worsening HF during their index admission. Of these, 4 patients were re-hospitalized within 30 days of discharge, all of which had a prior history of HF. Two had presented with acute hypoxic respiratory failure (AHRF), one with acute renal injury and one with a rectus sheath hematoma. In those readmitted, none had presented primarily with an acutely worsening HF state, however presenting BNP values were elevated and cBIN1 scores trended lower (1.5 ± 0.65 vs 2.6 ± 0.63, p = 0.04) as compared to those who were not readmitted.
Conclusion: Patients admitted with COVID-19 who experience HF syndrome have elevated BNP and are high risk to be readmitted. Those with low cBIN1 scores and elevated BNP remain at risk for re-hospitalization, but likely not for primary cardiovascular complications. In patients hospitalized with COVID-19, cBIN1 score provides insight regarding intrinsic health of cardiac muscle which is independent of natriuretic peptides, a reflection of volume overload or acute decompensation.
Methods: We performed a single-centered prospective cohort study of patients who were hospitalized with COVID-19 from September 2020 through April 2021. Blood serum specimens from enrolled patients were collected upon hospital admission, weekly and upon discharge for quantification of troponin T, B-natriuretic peptide (BNP) and, cBIN1. Demographics, medical histories and outcomes were captured from the hospitals’ electronic health records. New or worsening HF was defined as any new left ventricular systolic dysfunction, decrease in ejection fraction >5% or a decompensated state in the setting of a prior history of HF.
Results: A total of 41 patients were enrolled, of which 12 presented with new or worsening HF during their index admission. Of these, 4 patients were re-hospitalized within 30 days of discharge, all of which had a prior history of HF. Two had presented with acute hypoxic respiratory failure (AHRF), one with acute renal injury and one with a rectus sheath hematoma. In those readmitted, none had presented primarily with an acutely worsening HF state, however presenting BNP values were elevated and cBIN1 scores trended lower (1.5 ± 0.65 vs 2.6 ± 0.63, p = 0.04) as compared to those who were not readmitted.
Conclusion: Patients admitted with COVID-19 who experience HF syndrome have elevated BNP and are high risk to be readmitted. Those with low cBIN1 scores and elevated BNP remain at risk for re-hospitalization, but likely not for primary cardiovascular complications. In patients hospitalized with COVID-19, cBIN1 score provides insight regarding intrinsic health of cardiac muscle which is independent of natriuretic peptides, a reflection of volume overload or acute decompensation.
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