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Prognostic significance of admission heart failure in patients with non-ST-elevation acute coronary syndromes (from the Canadian Acute Coronary Syndrome Registries).
Am J Cardiol. 2006 Aug 15; 98(4):470-3.AJ

Abstract

We evaluated the in-hospital and 1-year outcomes and predictors of admission heart failure in patients with non-ST-elevation acute coronary syndromes (NSTE-ACSs) without previous heart failure. We analyzed 4,825 patients with NSTE-ACS without a history of congestive heart failure who were included in the multicenter Canadian ACS Registries. Patients in Killip's class II/III on admission (n = 559, 11.6%) were compared with patients in Killip's class I. Patients with heart failure on admission were older (72 [64, 79] vs 64 [54, 73] years, p < 0.0001), with higher baseline creatinine levels (96 vs 88 mmol/dl, p <0.0001), more diabetes (32.2% vs 22.8%, p < 0.0001), hypertension (58% vs 52.4%, p = 0.014), previous myocardial infarction (MI; 38.9% vs 30.3%, p < 0.0001), previous stroke (13.5% vs 7.4%, p < 0.0001), and had more ST depression on admission (27.7% vs 17.3%, p < 0.0001). In-hospital treatment was similar except for a lower rate of aspirin therapy and fewer coronary interventions. Crude event rates were significantly higher in patients with heart failure (in-hospital death 3.6% vs 1.1%, p < 0.0001; death or MI 7.9% vs 4.7%, p = 0.0011; stroke 1.1% vs 0.4%, p = 0.03). One-year event rates were also higher in patients with heart failure (death 14.6% vs 4.4%, p < 0.0001; MI 9.3% vs 6.6%, p = 0.03; death or MI 21.5% vs 10.3%, p < 0.0001). Variables independently associated with heart failure were age (odds ratio 1.57, 95% confidence interval 1.43 to 1.73), diabetes mellitus (odds ratio 1.53, 95% confidence interval 1.24 to 1.89), admission ST depression (odds ratio 1.52, 95% confidence interval 1.22 to 1.90), previous MI, and baseline creatinine. Heart failure on admission was an independent predictor of in-hospital death, death or MI, and stroke and of 1-year death and death or MI. In conclusion, in patients with NSTE-ACS, heart failure on admission is associated with increased short- and long-term rates of death and MI.

Authors+Show Affiliations

The Terrence Donnelly Heart Centre, Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16893699

Citation

Segev, Amit, et al. "Prognostic Significance of Admission Heart Failure in Patients With non-ST-elevation Acute Coronary Syndromes (from the Canadian Acute Coronary Syndrome Registries)." The American Journal of Cardiology, vol. 98, no. 4, 2006, pp. 470-3.
Segev A, Strauss BH, Tan M, et al. Prognostic significance of admission heart failure in patients with non-ST-elevation acute coronary syndromes (from the Canadian Acute Coronary Syndrome Registries). Am J Cardiol. 2006;98(4):470-3.
Segev, A., Strauss, B. H., Tan, M., Mendelsohn, A. A., Lai, K., Ashton, T., Fitchett, D., Grima, E., Langer, A., & Goodman, S. G. (2006). Prognostic significance of admission heart failure in patients with non-ST-elevation acute coronary syndromes (from the Canadian Acute Coronary Syndrome Registries). The American Journal of Cardiology, 98(4), 470-3.
Segev A, et al. Prognostic Significance of Admission Heart Failure in Patients With non-ST-elevation Acute Coronary Syndromes (from the Canadian Acute Coronary Syndrome Registries). Am J Cardiol. 2006 Aug 15;98(4):470-3. PubMed PMID: 16893699.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic significance of admission heart failure in patients with non-ST-elevation acute coronary syndromes (from the Canadian Acute Coronary Syndrome Registries). AU - Segev,Amit, AU - Strauss,Bradley H, AU - Tan,Mary, AU - Mendelsohn,Aurora A, AU - Lai,Kevin, AU - Ashton,Thomas, AU - Fitchett,David, AU - Grima,Etienne, AU - Langer,Anatoly, AU - Goodman,Shaun G, AU - ,, Y1 - 2006/06/19/ PY - 2005/11/08/received PY - 2006/03/06/revised PY - 2006/03/06/accepted PY - 2006/8/9/pubmed PY - 2006/9/22/medline PY - 2006/8/9/entrez SP - 470 EP - 3 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 98 IS - 4 N2 - We evaluated the in-hospital and 1-year outcomes and predictors of admission heart failure in patients with non-ST-elevation acute coronary syndromes (NSTE-ACSs) without previous heart failure. We analyzed 4,825 patients with NSTE-ACS without a history of congestive heart failure who were included in the multicenter Canadian ACS Registries. Patients in Killip's class II/III on admission (n = 559, 11.6%) were compared with patients in Killip's class I. Patients with heart failure on admission were older (72 [64, 79] vs 64 [54, 73] years, p < 0.0001), with higher baseline creatinine levels (96 vs 88 mmol/dl, p <0.0001), more diabetes (32.2% vs 22.8%, p < 0.0001), hypertension (58% vs 52.4%, p = 0.014), previous myocardial infarction (MI; 38.9% vs 30.3%, p < 0.0001), previous stroke (13.5% vs 7.4%, p < 0.0001), and had more ST depression on admission (27.7% vs 17.3%, p < 0.0001). In-hospital treatment was similar except for a lower rate of aspirin therapy and fewer coronary interventions. Crude event rates were significantly higher in patients with heart failure (in-hospital death 3.6% vs 1.1%, p < 0.0001; death or MI 7.9% vs 4.7%, p = 0.0011; stroke 1.1% vs 0.4%, p = 0.03). One-year event rates were also higher in patients with heart failure (death 14.6% vs 4.4%, p < 0.0001; MI 9.3% vs 6.6%, p = 0.03; death or MI 21.5% vs 10.3%, p < 0.0001). Variables independently associated with heart failure were age (odds ratio 1.57, 95% confidence interval 1.43 to 1.73), diabetes mellitus (odds ratio 1.53, 95% confidence interval 1.24 to 1.89), admission ST depression (odds ratio 1.52, 95% confidence interval 1.22 to 1.90), previous MI, and baseline creatinine. Heart failure on admission was an independent predictor of in-hospital death, death or MI, and stroke and of 1-year death and death or MI. In conclusion, in patients with NSTE-ACS, heart failure on admission is associated with increased short- and long-term rates of death and MI. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/16893699/Prognostic_significance_of_admission_heart_failure_in_patients_with_non_ST_elevation_acute_coronary_syndromes__from_the_Canadian_Acute_Coronary_Syndrome_Registries__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(06)00816-2 DB - PRIME DP - Unbound Medicine ER -