Background: The global rise of obesity and its association with cardiovascular risk factors (CVRF) have highlighted connection to chronic heart failure (CHF). Paradoxically, obese CHF patients often experience better outcomes, a phenomenon known as the ‘obesity paradox’. This study evaluated paradox’ within large cohort in Germany explored how varying degrees affect HF outcome. Methods: Anonymized health claims data from largest German insurer (AOK) for years 2014–2015 were utilized analyze...

Abstract Background Female sex was reported to be associated with an unfavorable outcome in acute myocardial infarction (AMI). In this nationwide analysis we assessed differences outcomes of AMI and recent trends patient healthcare. Methods We analyzed 875 735 German cases hospitalized a main diagnosis ST‐ (STEMI) non ST‐elevation (NSTEMI) between January 01 2014 December 31 2017 regarding morbidity, in‐hospital mortality treatments. A multivariable logistic regression model designed...

The prevalence of chronic limb-threatening ischaemia (CLTI) is increasing and available data often derive from cohorts with various selection criteria. In the present study, we included CLTI patients studied sex-related differences in their risk profile, vascular procedures, long-term outcome.We analysed 199 953 unselected largest public health insurance Germany (AOK: Local healthcare funds), hospitalized between 2010 2017 for a main diagnosis CLTI. A baseline period 2 years before index...

Background To evaluate the association of age with long-term outcome after thrombectomy. Methods In a retrospective cohort study based on routine healthcare data from Germany between 2010 and 2018, we included 18 506 patients acute ischaemic stroke treated mechanical Association mortality, disability, level care at 1 year was assessed. Results The median 76 years, 36.3% were aged ≥80 years 55.8% women. Patients compared those <80 had higher mortality (55.4% vs 28.5%; adjusted HR 1.13; 95%...

We investigated the safety and efficacy of debulking infrainguinal lesions in patients with peripheral artery disease (PAD) undergoing endovascular revascularization (EVR) as part RECording Courses vascular Diseases (RECCORD) registry. Patient lesion specific characteristics, including complexity score (LCS) were analyzed. The primary endpoint encompassed: (i) clinical improvement Rutherford categories, (ii) index limb re-interventions, (iii) major amputations during follow-up. secondary...

The prevalence of lower extremity artery disease (LEAD) is increasing worldwide and sex-related differences are a current matter debate.We analysed claims data on unselected patients with in-patient treatment for LEAD intermittent claudication (IC; Rutherford grade 1-3) from 01.01.2014 to 31.12.2015. Data files included diagnostic procedural information two years before index, five-year follow-up.Our analysis comprised 42,197 IC patients, thereof 28,520 (68%) male. Male were younger (median:...

Acute myocardial infarction (AMI) is the leading cause of death worldwide. Outcome has improved during last decades due to secondary prevention and widespread coronary interventions, but recent studies still show sex differences insufficient drug adherence. We aimed determine in treatment strategies outcomes between women men with ST-elevation (STEMI) Germany.From Federal Association Local Health Insurance Funds (Allgemeine Ortskrankenkasse), 175,187 patients were identified who hospitalized...

Background: Temporary mechanical circulatory support devices (tMCS) are increasingly being used in patients with infarct-associated cardiogenic shock (AMICS). Evidence on patient selection, complications and long-term outcomes is lacking. We aim to investigate differences clinical characteristics, between receiving no tMCS or either intra-aortic balloon pump (IABP), veno-arterial extracorporeal membrane oxygenation (V-A ECMO) Impella® for AMICS, a particular focus outcomes. Methods: Using...

In the past decade, there have been major improvements in control of risk factors, acute stroke therapies, and rehabilitation after availability high-quality evidence guidelines on best practices phase. this changing landscape, we aimed to investigate admission rates, time trends, outcomes during period 2014-2019 using German nationwide data.We obtained data all hospitalizations by Federal Statistical Office. All hospitalized cases adults (age 18 years or older) with from were analyzed...

Depression and anxiety (DA) are common mental disorders in patients with chronic diseases, but the research regarding their prevalence heart transplantation (HTx) is still limited. We performed an analysis of prognostic relevance DA who underwent HTx between 2010 2018 Germany. Data were obtained from Allgemeine Ortskrankenkasse (AOK), which largest public health insurance provider. Overall, 694 identified. More than a third them diagnosed before undergoing (n = 260, 37.5%). Patients more...

Vitamin-K antagonists (VKAs) have widely been replaced by non-VKA oral anticoagulants (NOACs). This includes Austria, Germany and Switzerland, where as VKA, instead of warfarin, the much longer-acting phenprocoumon is used, which was not compared to NOACs in clinical trials.

Abstract Background and Aims Current knowledge about upper extremity artery disease (UEAD) is scarce. This study aimed to evaluate the prevalence, treatment patterns, short- long-term outcomes of patients suffering from UEAD. Methods Retrospective health claims data who were hospitalized with a primary diagnosis UEAD between 2010 2017 analysed. The obtained 11 legally independent statutory insurance funds ‘AOK-Die Gesundheitskasse’. Risk factors, comorbidities, pharmacotherapy,...

Survival after ST-elevation myocardial infarction (STEMI) as a first event in Germany was analyzed.Adults with first-event STEMI were included for analysis on the basis of insurance data from German health provider (AOK; approximately 26 million members; median follow-up 48.5 months). The primary endpoints 30-day mortality, reinfarction or death, major adverse cardiovascular and cerebro - vascular events (MACCE), long-term survival more than 90 days, overall (OS).STEMI occurred 17 444...

The impact of the encounter between coronary heart disease (CHD) and cancer, in particular hematologic malignancies (HM), remains poorly understood.

Summary: Background: Peripheral artery disease (PAD) frequently leads to hospital admission. Sex related differences in in-patient care are a current matter of debate. Patients and methods: Data were provided from the German national sample by Federal Bureau Statistics (DESTATIS). Trends on risk profiles, therapeutic procedures, outcomes evaluated 2014 until 2019 stratified sex PAD severity. Results: Two-thirds an annual >191,000 cases applied male sex. Chronic limb-threatening ischemia...

Background: Sex-related differences may influence the outcome of endovascular revascularization (EVR) in patients with lower extremity arterial disease (LEAD) even under optimized healthcare supply. Patients and methods: LEAD who underwent EVR at Department Cardiology I - Coronary Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Germany between 2014 2016 were included into retrospective study. Detailed information on risk factors co-morbidities, medication, related...

Background: Acute myocardial infarction (AMI) and cancer are common serious diseases. As the prognosis treatment of both diseases has improved, more patients will suffer an AMI. Unfortunately, data on these “double hit” is scarce. Methods: From largest public German health insurance, anonymized all with pre-existing who were hospitalized due to ST-elevation MI (STEMI) between 2010 2017 analyzed followed-up until 2018. Results: Of 175,262 STEMI patients, 27,213 had (15.5%). Most frequent skin...

Objectives To investigate the clinical benefit of endovascular revascularisation (EVR) in octogenarian (aged ≥80 years) patients with lower extremity artery disease (LEAD). Design Retrospective single-centre study. Setting University hospital a specialised centre for vascular medicine. Participants 681 LEAD undergoing EVR between 2010 and 2016 were stratified by age. Main outcome measure Technical success, complications mortality. Results The cohort comprised 172 (25.3%) 509 (74.7%)...

Abstract Acute myocardial infarction-associated cardiogenic shock (AMICS) remains a condition with high mortality. Some patients require mechanical circulatory support (MCS) as their deteriorates. Sex-specific differences in risk factors and outcomes of cardiovascular disease have previously been described but are inconclusive regarding the use MCS AMICS. We aimed to investigate these focus on long-term outcomes. Health claim data from AOK – Die Gesundheitskasse (local health care funds) for...

Abstract Background Cardiovascular disease is often associated with chronic kidney (CKD), resulting in an increased risk for poor outcome. We sought to determine short-term mortality and overall survival ST-elevation myocardial infarction (STEMI) patients different stages of CKD. Methods In our retrospective cohort study health insurance claims data the Allgemeine Ortskrankenkasse (AOK), anonymized all STEMI hospitalized between 2010 2017 were analyzed regarding presence severity concomitant...

The one-sample log-rank test is the preferred method for analysing outcome of single-arm survival trials. It compares distribution patients with a prefixed reference curve that usually represents expected under standard care. However, classical tests assume known, ignoring it frequently estimated from historical data and therefore susceptible to sampling error. Neglecting variability can lead an inflated type I error rate, as shown in previous paper. Here, we propose new allows account...

Background: Specifically young women are at risk for a poor outcome after ST-elevation myocardial infarction (STEMI). We aimed to investigate sex- and age-specific differences in associate these results with adherence guideline-directed optimal medical therapy (OMT). Methods: Administrative insurance data (≈26 million insured) were screened patients aged 18-60 years STEMI. Patient demographics, details on in-hospital treatment, OMT its effect mortality assessed. Adherence was analyzed using...