Fecal Immunochemical Test and Helicobacter pylori Stool Antigen Co-Testing

Gastric cancer is a leading cause of cancer death globally. Although endoscopy-based screening has led to a decrease in gastric cancer mortality in Eastern Asian countries with populations at high risk, lack of risk stratification and the cost of health care infrastructure and trained personnel limit its use in most of the world. Availability of noninvasive biomarkers for the identification of high-risk individuals could optimize endoscopy-based screening programs for a more general application, including in regions where gastric cancer rates in the general population are low.

Leggi
Novembre 2024

Use of the walking and turning test to accurately discriminate between independently ambulatory community-dwelling older Thai adults with and without a history of falls: a retrospective diagnostic study

Objectives
This study developed and investigated the possibility of using the walking and turning test (WTT) to indicate fall risk in community-dwelling older adults.

Design
Retrospective diagnostic study.

Setting
The study was carried out in a community setting.

Participants
The study focused on community-dwelling older Thai adults.

Primary and secondary outcome measures
The participants were assessed based on demographics, fear of falls using a ‘yes/no’ question and the Short Falls Efficacy Scale International, as well as fall data in the previous 6 months. The participants then performed the WTT, timed up and go test, five times sit-to-stand test and handgrip strength test (HG) in random order.

Results
There were a total of 86 participants with an average age of 69.95±6.10 years (range from 60 to 88 years), most of whom were female (67.44%). 40 participants (46.51%) reported that they had fallen at least once in the previous 6 months. A comparison of various physical ability tests revealed significant differences between faller and non-faller participants (p

Leggi
Novembre 2024

Abstract 4143109: Association Between Frailty Testing through Timed Up-and-Go Test Time and Mortality in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy

Circulation, Volume 150, Issue Suppl_1, Page A4143109-A4143109, November 12, 2024. Background:The use of cardiac resynchronization therapy (CRT) devices has significantly increased in usage in recent years. Identifying predictors of mortality in CRT patients remains an area of investigation.Objective:To establish a relationship between timed up-and-go test time (TUGT) and mortality in heart failure patients (HF) with CRT devices.Methods:This retrospective study included 506 patients with heart failure with reduced ejection fraction (HFrEF) who underwent CRT implantation at our institution between 2017-2022. All patients were followed up with a multidisciplinary team, including electrophysiology and HF physicians about 6 months after CRT implantation, where frailty was assessed. We used TUGT as a measure of frailty and divided patients into 2 groups: TUGT: >15 seconds (n=73) and ≤15 seconds (n=433). The primary endpoint was a composite of left ventricular assist device implantation, transplant, or death at 2 years post-CRT. Data was collected retrospectively from electronic medical records.Results:The study population was 65.6% male, with a mean age of 69.1 years, and 79.4% of devices being CRT-D.Response was defined as an improvement in LVEF >5% with reduction in LVESV >10%; anybody not meeting this definition was classified as a non-responder. Responder and non-responder rates among TUGT >15 and TUGT15s have worse outcomes (Figure 1).Conclusion:Frailty testing using TUGT post-CRT implantation is a strong predictor of mortality in HFrEF patients after CRT implantation.

Leggi
Novembre 2024

Abstract 4141692: Second-by-second monitoring of SpO2 by wearable device during the six-minute walk test identifies patients at risk for worsening heart failure.

Circulation, Volume 150, Issue Suppl_1, Page A4141692-A4141692, November 12, 2024. Background:Assessment of exercise tolerance is crucial for risk stratification in patients with heart failure (HF), and the six-minute walk test (6MWT) is widely used. While the six-minute walk distance (6MWD) is an established metric, it shows significant variability among elderly patients due to numerous comorbidities and potential confounding factors, making relative risk assessment challenging. Therefore, a new comprehensive indicator for evaluating exercise tolerance in elderly patients with HF is required.Objective:This study aimed to evaluate the novel prognostic value of desaturation during the 6MWT, defined as the average decrease in peripheral oxygen saturation (ΔSpO2-Ex), in predicting rehospitalization in patients with HF.Methods:We retrospectively analyzed the data of 55 patients with acute HF aged ≥ 65 years who were prospectively registered at our hospital. The mean SpO2was calculated from data obtained at rest and during the 6MWT using a wearable pulse oximeter designed to record the SpO2value every second. ΔSpO2-Ex was defined as the difference between the highest SpO2at rest and average SpO2during the 6MWT. Patients were followed-up for 1 year for the composite outcome of rehospitalization due to HF exacerbation and cardiovascular death.Results:The mean age was 80.7 years, with 45 % being female. The mean 6MWD was 237.5 m, and the mean ΔSpO2-Ex was 5.8 %. Patients were categorized based on the cut-off values obtained from the ROC curve for both 6MWD and ΔSpO2-Ex. Kaplan-Meier analysis indicated a significantly higher risk of cardiovascular events when ΔSpO2-Ex exceeded 6.7 % compared to when the 6MWD was less than 220 m (HR 6.66, 95 % CI: 2.96-15.01, p

Leggi
Novembre 2024

Abstract 4146434: Factors Associated with Subsequent Catheterization and Identification of High-Grade Obstructive Coronary Artery Disease in Patients Without Known Coronary Disease and a Low to Moderate Short-Term Risk PET/CT Stress Test

Circulation, Volume 150, Issue Suppl_1, Page A4146434-A4146434, November 12, 2024. Background:PET/CT stress test may be performed to risk stratify patients including those without known coronary artery disease (CAD) who may be at risk for short-term adverse cardiac events. In patients with low- to moderate (LTM) risk for short-term MACE and without a known history of CAD, a small percentage of these patients will undergo a coronary angiogram within 90-days, of which some will be diagnosed with high-grade stenosis. The purpose of this study is to determine factors associated with this approach and findings.Methods:Patients without a history of known CAD (n=43,271) undergoing a PET/CT from 2018-2023 at Intermountain Health, with scan interpreted clinically as LTM short-term risk for adverse cardiac events, and ischemic burden 70% stenosis in any vessel), an a priori list of clinical data and PET/CT results were examined.Results:Within 90 days of the LTM risk PET/CT, 3,163 (8.2%) had a coronary angiogram. Of these, 806 (25.5% of angiograms and 2.1% of total LTM) had high-grade CAD. The PET/CT ancillary findings were associated with the largest odds of performing an angiogram and the presence of high-grade CAD (Tables). Factors most likely to be associated with performing an angiogram were an ischemic burden of 7.5-10% (adjusted-OR [adj. OR]=11.54), coronary artery calcification (CAC) score of >300 (adj.-OR =1.62), and myocardial blood flow (MBF) of MBF 2.3). Other clinical parameters associated, after adjustment, with an angiogram were age, male sex, hypertension, elevated troponin, and inpatient status. Many of the same factors were found to be associated with the identification of high-grade CAD. However, being an inpatient was associated with increased odds of angiogram but a decrease in odds of high-grade CAD.Conclusions:In patients without a known history of CAD who underwent PET/CT clinically adjudicated as LTM short-term risk and ischemic burden

Leggi
Novembre 2024