Browsing by Author "Davidovic, Goran (14008112400)"

Heart failure is recognized as a modern epidemic and despite advances in therapy and research, heart failure still carries an ominous prognosis and a significant socioeconomic burden. The main aim of this paper is to demonstrate how novel Decision Support System (DSS) and computational platform like INTELHEART can transform the future of healthcare and early diagnosis of heart failure. The main idea is integration of patient-specific data (i.e. demographic and physical characteristics, medical history, symptoms and signs) and results obtained using existing and novel diagnostic technologies into the cloud environment. Data will be used by different tools for machine learning and computational modelling, developing virtual patient population. Moreover, voice as a biomarker will be collected among participating patients, in order to create a VoiceHeart mobile app. INTELHEART represents a transformative advancement in heart failure care, aiming to make treatment more personalized, and proactive. This initiative centers on precision medicine, using AI-driven analysis and a powerful DSS alongside the cloud-based platform and VoiceHeart mobile app to assist both clinicians and patients. Additionally, it incorporates assessments of psychological resilience and emotional well-being, addressing the oftenoverlooked mental health factors essential to comprehensive heart failure management. © 2024 IEEE.

Heart failure is recognized as a modern epidemic and despite advances in therapy and research, heart failure still carries an ominous prognosis and a significant socioeconomic burden. The main aim of this paper is to demonstrate how novel Decision Support System (DSS) and computational platform like INTELHEART can transform the future of healthcare and early diagnosis of heart failure. The main idea is integration of patient-specific data (i.e. demographic and physical characteristics, medical history, symptoms and signs) and results obtained using existing and novel diagnostic technologies into the cloud environment. Data will be used by different tools for machine learning and computational modelling, developing virtual patient population. Moreover, voice as a biomarker will be collected among participating patients, in order to create a VoiceHeart mobile app. INTELHEART represents a transformative advancement in heart failure care, aiming to make treatment more personalized, and proactive. This initiative centers on precision medicine, using AI-driven analysis and a powerful DSS alongside the cloud-based platform and VoiceHeart mobile app to assist both clinicians and patients. Additionally, it incorporates assessments of psychological resilience and emotional well-being, addressing the oftenoverlooked mental health factors essential to comprehensive heart failure management. © 2024 IEEE.

Background Limited data are available on the outcome of primary percutaneous coronary intervention (PCI) in octogenarian patients, as the elderly are under-represented in randomized trials. This study aims to provide insights on clinical characteristics, management and outcome of the elderly and very elderly presenting with STEMI. Methods 2225 STEMI patients ≥ 70 years old (mean age 76.8 ± 5.1 years and 53.8% men) were admitted into the network of the ISACS-TC registry. Of these patients, 72.8% were ≥ 70 to 79 years old (elderly) and 27.2% were ≥ 80 years old (very-elderly). The primary end-point was 30-day mortality. Results Thirty-day mortality rates were 13.4% in the elderly and 23.9% in the very-elderly. Primary PCI decreased the unadjusted risk of death both in the elderly (OR: 0.32, 95% CI: 0.24–0.43) and very-elderly patients (OR: 0.45, 95% CI 0.30–0.68), without significant difference between groups. In the very-elderly hypertension and Killip class ≥ 2 were the only independent factors associated with mortality; whereas in the elderly female gender, prior stroke, chronic kidney disease and Killip class ≥ 2 were all factors independently associated with mortality. Factors associated with the lack of use of reperfusion were female gender and atypical chest pain in the very-elderly and in the elderly; in the elderly, however, there were some more factors, namely: history of diabetes, current smoking, prior stroke, Killip class ≥ 2 and history chronic kidney disease. Conclusions Age is relevant in the prognosis of STEMI, but its importance should not be considered secondary to other major clinical factors. Primary PCI appears to have beneficial effects in the octogenarian STEMI patients. © 2016

Background There is conflicting information about sex differences in presentation, treatment, and outcome after acute coronary syndromes (ACS) in the era of reperfusion therapy and percutaneous coronary intervention. The aim of this study was to examine presentation, acute therapy, and outcomes of men and women with ACS with special emphasis on their relationship with younger age (≤ 65 years). Methods From January 2010 to June 2015, we enrolled 5140 patients from 3 primary PCI capable hospitals. Patients were registered according to the International Survey of Acute Coronary Syndrome in Transitional Countries (ISACS-TC) registry protocol (ClinicalTrials.gov: NCT01218776). The primary outcome was the incidence of in-hospital mortality. Results The study population was constituted by 2876 patients younger than 65 years and 2294 patients older. Women were older than men in both the young (56.2 ± 6.6 vs. 54.1 ± 7.4) and old (74.9 ± 6.4 vs. 73.6 ± 6.0) age groups. There were 3421 (66.2%) patients with ST elevation ACS (STE-ACS) and 1719 (33.8%) patients without ST elevation ACS (NSTE-ACS). In STE-ACS, the percentage of patients who failed to receive reperfusion was higher in women than in men either in the young (21.7% vs. 15.8%) than in the elderly (35.2% vs. 29.6%). There was a significant higher mortality in women in the younger age group (age-adjusted OR 1.52, 95% CI: 1.01–2.29), but there was no sex difference in the older group (age-adjusted OR 1.10, 95% CI: 0.87–1.41). Significantly sex differences in mortality were not seen in NSTE-ACS patients. Conclusions In-hospital mortality from ACS is not different between older men and women. A higher short-term mortality can be seen only in women with STEMI and age of 65 or less. © 2016

Background and aims: An increasing proportion of women believe that smoking few cigarettes daily substantially reduces their risk of developing cardiovascular (CV) related disorders. The effect of low intensity smoking is still largely understudied. We investigated the relation among sex, age, cigarette smoking and ST segment elevation myocardial infarction (STEMI) as initial manifestation of CV disease. Methods: We analyzed data of 50,713 acute coronary syndrome patients with no prior manifestation of CV disease from the ISACS-Archives (NCT04008173) registry. We compared the rates of STEMI in current smokers (n = 11,530) versus nonsmokers (n = 39,183). Results: In the young middle age group (<60 years), there was evidence of a more harmful effect in women compared with men (RR ratios: 1.90; 95% CI: 1.69–2.14 versus 1.68; 95% CI: 1.56–1.80). This association persisted even in women who smoked 1 to 10 packs per year (RR ratios: 2.02; 95% CI: 1.65 to 2.48 versus 1.38; 95% CI: 1.22 to 1.57). In the older group, rates of STEMI were similar for women and men (RR ratios: 1.36; 95% CI: 1.22–1.53 versus 1.39; 95% CI: 1.28–1.50). STEMI was associated with a twofold higher 30-day mortality rate in young middle age women compared with men of the same age (odds ratios, 5.54; 95% CI, 3.83–8.03 vs. 2.93; 95% CI, 2.33–3.69). Conclusions: Low intensity smoking provides inadequate protection in young - middle age women as they still have a substantially higher rate of STEMI and related mortality compared with men even smoking less than 10 packs per year. This finding is worrying as more young - middle age women are smoking, and rates of smoking among young-middle age men continue to fall. © 2021 Elsevier B.V.