Athar A Badar1, Ana Cristina Perez-Moreno1, Nathaniel M Hawkins1, Pardeep S Jhund1, Alan P T Brunton1, Inder S Anand1, Robert S McKelvie1, Michel Komajda1, Michael R Zile1, Peter E Carson1, Roy S Gardner1, Mark C Petrie1, John J V McMurray2. 1. From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.). 2. From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.). john.mcmurray@glasgow.ac.uk.
Abstract
BACKGROUND: The aim of our study was to investigate the relationship between coronary artery disease (CAD), angina, and clinical outcomes in patients with heart failure and preserved ejection fraction enrolled in the irbesartan in patients with heart failure and preserved systolic function (I-Preserve) trial. METHODS AND RESULTS: The mean follow-up period for the 4128 patients enrolled in I-Preserve was 49.5 months. Patients were divided into 4 mutually exclusive groups according to history of CAD and angina: patients with no history of CAD or angina (n=2008), patients with no history of CAD but a history of angina (n=649), patients with a history of CAD but no angina (n=468), and patients with a history of CAD and angina (n=1003); patients with no known CAD or angina were the reference group. After adjustment for other prognostic variables using Cox proportional-hazard models, patients with CAD but no angina were found to be at higher risk of all-cause mortality (hazard ratio [HR], 1.58 [1.22-2.04]; P<0.01) and sudden death (HR, 2.12 [1.33-3.39]; P<0.01), compared with patients with no CAD or angina. Patients with CAD and angina were also at higher risk of all-cause mortality (HR, 1.29 [1.05-1.59]; P=0.02) and sudden death (HR, 1.83 [1.24-2.69]; P<0.01) compared with the same reference group and had the highest risk of unstable angina or myocardial infarction (HR, 5.84 [3.43-9.95]; P<0.01). CONCLUSIONS: Patients with heart failure and preserved ejection fraction and CAD are at higher risk of all-cause mortality and sudden death when compared with those without CAD. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00095238.
BACKGROUND: The aim of our study was to investigate the relationship between coronary artery disease (CAD), angina, and clinical outcomes in patients with heart failure and preserved ejection fraction enrolled in the irbesartan in patients with heart failure and preserved systolic function (I-Preserve) trial. METHODS AND RESULTS: The mean follow-up period for the 4128 patients enrolled in I-Preserve was 49.5 months. Patients were divided into 4 mutually exclusive groups according to history of CAD and angina: patients with no history of CAD or angina (n=2008), patients with no history of CAD but a history of angina (n=649), patients with a history of CAD but no angina (n=468), and patients with a history of CAD and angina (n=1003); patients with no known CAD or angina were the reference group. After adjustment for other prognostic variables using Cox proportional-hazard models, patients with CAD but no angina were found to be at higher risk of all-cause mortality (hazard ratio [HR], 1.58 [1.22-2.04]; P<0.01) and sudden death (HR, 2.12 [1.33-3.39]; P<0.01), compared with patients with no CAD or angina. Patients with CAD and angina were also at higher risk of all-cause mortality (HR, 1.29 [1.05-1.59]; P=0.02) and sudden death (HR, 1.83 [1.24-2.69]; P<0.01) compared with the same reference group and had the highest risk of unstable angina or myocardial infarction (HR, 5.84 [3.43-9.95]; P<0.01). CONCLUSIONS:Patients with heart failure and preserved ejection fraction and CAD are at higher risk of all-cause mortality and sudden death when compared with those without CAD. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00095238.
Authors: Meaghan Lunney; Marinella Ruospo; Patrizia Natale; Robert R Quinn; Paul E Ronksley; Ioannis Konstantinidis; Suetonia C Palmer; Marcello Tonelli; Giovanni Fm Strippoli; Pietro Ravani Journal: Cochrane Database Syst Rev Date: 2020-02-27
Authors: Cassandra Freitas; Xuesong Wang; Yin Ge; Heather J Ross; Peter C Austin; Peter S Pang; Dennis T Ko; Michael E Farkouh; Therese A Stukel; John J V McMurray; Douglas S Lee Journal: CJC Open Date: 2020-02-24