Acute heart failure precipitated by acute coronary syndrome - patient characteristics, management and survival

Le résumé fourni par la source

Purpose: Acute coronary syndrome (ACS) may precipitate up to one third of acute heart failure (AHF) cases. As scientific data is scarce, we assessed characteristics, management and survival of patients with ACS as a precipitating factor of AHF (AHF-ACS). Methods: Data of 620 patients hospitalized due to AHF were prospectively collected in a multicenter study. All-cause mortality was assessed during 12 months follow-up. The data were compared between patients with and without ACS. Comparisons between groups were performed by χ2 test, t-test or Mann-Whitney U as appropriate. Survival analyses were performed using Kaplan-Meier method and multivariable logistic regression. Results: AHF-ACS patients (32%) had significantly more often coronary artery disease, diabetes and hypercholesterolemia as underlying diseases. Most of the AHF-ACS patients presented with de novo AHF (61% vs 43% in non-ACS, p<0.001). There were no significant differences between the two groups in blood pressure, heart rate or biochemistry (eGFR, sodium, hemoglobin, CRP) on admission. Intravenous nitrates, furosemide, opioids, inotropes and vasopressors as well as non-invasive ventilation and invasive coronary procedures (angiography, PCI, CABG) were used significantly more often in AHF-ACS patients (p<0.001 for all). Although survival at 12 months was similar in the two groups, early mortality was significantly higher in patients with AHF-ACS (Figure). In fact, ACS was a significant predictor of 30-day prognosis in multivariable analysis (adjusted OR 1.9, 95% CI 1.06-3.52, p=0.033). ![Figure][1] Figure 1 Conclusion: AHF-ACS patients differ from those without ACS in terms of underlying diseases and treatment, but not in clinical parameters measured on admission. ACS in AHF was independently related to increased short-term mortality. [1]: pending:yes

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.