Tags

Type your tag names separated by a space and hit enter

Acute heart failure with and without acute coronary syndrome: clinical correlates and prognostic impact (From the HEARTS registry).
BMC Cardiovasc Disord. 2016 May 20; 16:98.BC

Abstract

BACKGROUND

Little is know about the outcomes of acute heart failure (AHF) with acute coronary syndrome (ACS-AHF), compared to those without ACS (NACS-AHF).

METHODS

We conducted a prospective registry of AHF patients involving 18 hospitals in Saudi Arabia between October 2009 and December 2010. In this sub-study, we compared the clinical correlates, management and hospital course, as well as short, and long-term outcomes between AHF patients with and without ACS.

RESULTS

Of the 2609 AHF patients enrolled, 27.8 % presented with ACS. Compared to NACS-AHF patients, ACS-AHF patients were more likely to be old males (Mean age = 62.7 vs. 60.8 years, p = 0.003, and 73.8 % vs. 62.7 %, p < 0.001, respectively), and to present with De-novo heart failure (56.6 % vs. 28.1 %, p < 0.001). Additionally they were more likely to have history of ischemic heart disease, diabetes, dyslipidemia, and less likely to have chronic kidney disease (p < 0.001 for all comparisons). The prevalence of severe LV systolic dysfunction (EF < 30 %) was higher in ACS-AHF patients. During hospital stay, ACS-AHF patients were more likely to develop shock (p < 0.001), recurrent heart failure (p = 0.02) and needed more mechanical ventilation (p < 0.001). β blockers and Angiotensin Converting Enzyme inhibitors were used more often in ACS-AHF patients (p = 0.001 and, p = 0.004 respectively). ACS- AHF patients underwent more coronary angiography and had higher prevalence of multi-vessel coronary artery disease (p < 0.001 for all comparisons). The unadjusted hospital and one-month mortality were higher in ACS-AHF patients (OR = 1.6 (1.2-2.2), p = 0.003 and 1.4 (1.0-1.9), p = 0.026 respectively). A significant interaction existed between the level of left ventricular ejection fraction and ACS-AHF status. After adjustment, ACS-AHF status was only significantly associated with hospital mortality (OR = 1.6 (1.1-2.4), p = 0.019). The three-years survival following hospital discharge was not different between the two groups.

CONCLUSION

AHF patients presenting with ACS had worse hospital prognosis, and an equivalent long-term survival compared to AHF patients without ACS. These findings underscore the importance of timely recognition and management of AHF patients with concomitant ACS given their distinct presentation and underlying pathophysiology compared to other AHF patients.

Authors+Show Affiliations

Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia.King Salman Heart Center, King Fahd Medical City, Riyadh, Saudi Arabia.Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia.Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia.Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia.King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.Madina Cardiac Center, Al Madina Al Monaoarah, Saudi Arabia.Prince Sultan Cardiac Center, Hafouf, Saudi Arabia.King Fahad General Hospital, Jeddah, Saudi Arabia.North West Armed Forces Hospital, Tabuk, Saudi Arabia.Armed Forces Hospital Southern Region, Khamis Mushayt, Saudi Arabia.National Guard Hospital, Jeddah, Saudi Arabia.Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia.Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia. tkashour@gmail.com. Cardiac Sciences, King Khalid University Hospital, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Saudi Arabia. tkashour@gmail.com.

Pub Type(s)

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

Language

eng

PubMed ID

27206336

Citation

AlFaleh, Hussam, et al. "Acute Heart Failure With and Without Acute Coronary Syndrome: Clinical Correlates and Prognostic Impact (From the HEARTS Registry)." BMC Cardiovascular Disorders, vol. 16, 2016, p. 98.
AlFaleh H, Elasfar AA, Ullah A, et al. Acute heart failure with and without acute coronary syndrome: clinical correlates and prognostic impact (From the HEARTS registry). BMC Cardiovasc Disord. 2016;16:98.
AlFaleh, H., Elasfar, A. A., Ullah, A., AlHabib, K. F., Hersi, A., Mimish, L., Almasood, A., Al Ghamdi, S., Ghabashi, A., Malik, A., Hussein, G. A., Al-Murayeh, M., Abuosa, A., Al Habeeb, W., & Kashour, T. S. (2016). Acute heart failure with and without acute coronary syndrome: clinical correlates and prognostic impact (From the HEARTS registry). BMC Cardiovascular Disorders, 16, 98. https://doi.org/10.1186/s12872-016-0267-6
AlFaleh H, et al. Acute Heart Failure With and Without Acute Coronary Syndrome: Clinical Correlates and Prognostic Impact (From the HEARTS Registry). BMC Cardiovasc Disord. 2016 May 20;16:98. PubMed PMID: 27206336.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute heart failure with and without acute coronary syndrome: clinical correlates and prognostic impact (From the HEARTS registry). AU - AlFaleh,Hussam, AU - Elasfar,Abdelfatah A, AU - Ullah,Anhar, AU - AlHabib,Khalid F, AU - Hersi,Ahmad, AU - Mimish,Layth, AU - Almasood,Ali, AU - Al Ghamdi,Saleh, AU - Ghabashi,Abdullah, AU - Malik,Asif, AU - Hussein,Gamal A, AU - Al-Murayeh,Mushabab, AU - Abuosa,Ahmed, AU - Al Habeeb,Waleed, AU - Kashour,Tarek S, Y1 - 2016/05/20/ PY - 2015/10/23/received PY - 2016/04/29/accepted PY - 2016/5/22/entrez PY - 2016/5/22/pubmed PY - 2016/12/15/medline KW - Acute coronary syndrome complications/mortality/physiopathology KW - Heart failure complications/mortality/physiopathology KW - Hospital Mortality KW - Prospective Studies KW - Saudi Arabia/epidemiology SP - 98 EP - 98 JF - BMC cardiovascular disorders JO - BMC Cardiovasc Disord VL - 16 N2 - BACKGROUND: Little is know about the outcomes of acute heart failure (AHF) with acute coronary syndrome (ACS-AHF), compared to those without ACS (NACS-AHF). METHODS: We conducted a prospective registry of AHF patients involving 18 hospitals in Saudi Arabia between October 2009 and December 2010. In this sub-study, we compared the clinical correlates, management and hospital course, as well as short, and long-term outcomes between AHF patients with and without ACS. RESULTS: Of the 2609 AHF patients enrolled, 27.8 % presented with ACS. Compared to NACS-AHF patients, ACS-AHF patients were more likely to be old males (Mean age = 62.7 vs. 60.8 years, p = 0.003, and 73.8 % vs. 62.7 %, p < 0.001, respectively), and to present with De-novo heart failure (56.6 % vs. 28.1 %, p < 0.001). Additionally they were more likely to have history of ischemic heart disease, diabetes, dyslipidemia, and less likely to have chronic kidney disease (p < 0.001 for all comparisons). The prevalence of severe LV systolic dysfunction (EF < 30 %) was higher in ACS-AHF patients. During hospital stay, ACS-AHF patients were more likely to develop shock (p < 0.001), recurrent heart failure (p = 0.02) and needed more mechanical ventilation (p < 0.001). β blockers and Angiotensin Converting Enzyme inhibitors were used more often in ACS-AHF patients (p = 0.001 and, p = 0.004 respectively). ACS- AHF patients underwent more coronary angiography and had higher prevalence of multi-vessel coronary artery disease (p < 0.001 for all comparisons). The unadjusted hospital and one-month mortality were higher in ACS-AHF patients (OR = 1.6 (1.2-2.2), p = 0.003 and 1.4 (1.0-1.9), p = 0.026 respectively). A significant interaction existed between the level of left ventricular ejection fraction and ACS-AHF status. After adjustment, ACS-AHF status was only significantly associated with hospital mortality (OR = 1.6 (1.1-2.4), p = 0.019). The three-years survival following hospital discharge was not different between the two groups. CONCLUSION: AHF patients presenting with ACS had worse hospital prognosis, and an equivalent long-term survival compared to AHF patients without ACS. These findings underscore the importance of timely recognition and management of AHF patients with concomitant ACS given their distinct presentation and underlying pathophysiology compared to other AHF patients. SN - 1471-2261 UR - https://www.unboundmedicine.com/medline/citation/27206336/Acute_heart_failure_with_and_without_acute_coronary_syndrome:_clinical_correlates_and_prognostic_impact__From_the_HEARTS_registry__ L2 - https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-016-0267-6 DB - PRIME DP - Unbound Medicine ER -