Coronary angiography in worsening heart failure: determinants, findings and prognostic implications

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Ferreira, JP (Author) FMUP; Rossignol, P (Author) Other; Demissei, B (Author) Other; Sharma, A (Author) Other; Girerd, N (Author) Other; Anker, SD (Author) Other; Cleland, JG (Author) Other; Dickstein, K (Author) Other; Filippatos, G (Author) Other; Hillege, HL (Author) Other; Lang, CC (Author) Other; Metra, M (Author) Other; Ng, LL (Author) Other; Ponikowski, P (Author) Other; Samani, NJ (Author) Other; van Veldhuisen, DJ (Author) Other; Zwinderman, AH (Author) Other; Voors, A (Author) Other; Zannad, F (Author) Other

Journal

Title: Heart

Vol. 104

Pages: 606-613

ISSN: 1355-6037

Publisher: BMJ PUBLISHING GROUP

Indexing

ISI Web of Knowledge - 8 Citations

Scopus - 10 Citations

Other information

Authenticus ID: P-00N-TC6

DOI: 10.1136/heartjnl-2017-311750

Abstract (EN): Objectives Coronary angiography is regularly performed in patients with worsening signs and/or symptoms of heart failure (HF). However, little is known on the determinants, findings and associated clinical outcomes of coronary angiography performed in patients with worsening HF. Methods The BIOSTAT-CHF (a systems BIOlogy Study to TAilored Treatment in Chronic Heart Failure) programme enrolled 2516 patients with worsening symptoms and/or signs of HF, either hospitalised or in the outpatient setting. All patients were included in the present analysis. Results Of the 2516 patients included, 315 (12.5%) underwent coronary angiography within the 30 days after the onset of worsening symptoms and/or signs of HF. Subjects who underwent angiography were more often observed as inpatients, had more often an overt acute coronary syndrome, had higher troponin I levels, were younger and had better renal function (all p <= 0.01). Patients who underwent coronary angiography had a lower risk of the primary outcome of death and/or HF hospitalisation (adjusted HR=0.71, 95% CI 0.57 to 0.89, p=0.003) and death (adjusted HR=0.59, 95% CI 0.43 to 0.80, p=0.001). Among the patients who underwent coronary angiography, those with a coronary stenosis (39%) had a worse prognosis than those without stenosis (adjusted HR for the primary outcome=1.71, 95% CI 1.10 to 2.64, p=0.016). Conclusions Coronary angiography was performed in <13% of patients with symptoms and/or signs of worsening HF. These patients were remarkably different from those who did not undergo coronary angiography and had a lower risk of subsequent events. The presence of coronary stenosis on coronary angiography was associated with a worse prognosis.

Language: English

Type (Professor's evaluation): Dissemination

No. of pages: 8