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Influence of coronary artery disease and coronary revascularization status on outcomes in patients with acute heart failure syndromes: a report from OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failur

Abstract：

BACKGROUND:Coronary artery disease (CAD) is frequent among patients hospitalized with acute heart failure syndromes (AHFS). AIMS:To describe the influence of coronary revascularization status on survival in patients with AHFS. METHODS AND RESULTS:OPTIMIZE-HF enrolled 48,612 patients with AHFS from 259 U.S. hospitals. In-hospital data were obtained for all patients and post-discharge 60-90 day follow-up in a pre-specified 10% sample. CAD was associated with higher in-hospital (3.7% vs. 2.9%, OR 1.14, 95% CI 1.00-1.31) and post-discharge mortality (9.2% vs. 6.9%, HR 1.37, 95% CI 1.03-1.81) compared to no CAD. Post-discharge, patients with CAD who were not revascularized had higher mortality compared to patients without CAD (10.6% vs. 6.9%, HR 1.56, 95% CI 1.15-2.11). This association was similar in patients with left ventricular systolic dysfunction (EF <40%, adjusted HR 1.52, 95% CI 0.98-2.35) and preserved systolic function (EF > or =40%, adjusted HR1.58, 95% CI 1.05-2.39). Patients with CAD who were revascularized had similar mortality to patients without CAD (HR 1.06, 95% CI 0.62-1.80 for PSF, HR 1.13, 95% CI 0.71-1.80 for LVSD). CONCLUSIONS:In AHFS, patients with CAD have a higher 60-90 day post-discharge mortality compared to no-CAD patients. However, patients with CAD who are revascularized appear to have similar post-discharge mortality when compared to the no-CAD group. This suggests that revascularization status may confer a survival advantage in this high risk population.

journal_name

Eur J Heart Fail

journal_title

European journal of heart failure

authors

Rossi JS,Flaherty JD,Fonarow GC,Nunez E,Gattis Stough W,Abraham WT,Albert NM,Greenberg BH,O'Connor CM,Yancy CW,Young JB,Davidson CJ,Gheorghiade M

doi

10.1016/j.ejheart.2008.09.009

subject

Has Abstract

pub_date

2008-12-01 00:00:00

pages

1215-23

issue

eissn

1388-9842

issn

1879-0844

pii

S1388-9842(08)00464-9

journal_volume

pub_type

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Influence of coronary artery disease and coronary revascularization status on outcomes in patients with acute heart failure syndromes: a report from OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failur