Alberto Cordero1, Moisés Rodríguez-Mañero2, Vicente Bertomeu-González3, José M García-Acuña2, Aurora Baluja4, Rosa Agra-Bermejo2, Belén Álvarez-Álvarez2, Belén Cid2, Pilar Zuazola5, José R González-Juanatey2. 1. Departamento de Cardiología, Hospital Universitario de San Juan, Alicante, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain. Electronic address: acorderofort@gmail.com. 2. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Complejo Hospital Universitario de Santiago, Santiago de Compostela, A Coruña, Spain. 3. Departamento de Cardiología, Hospital Universitario de San Juan, Alicante, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain. 4. Departamento de Anestesiología, Cuidados Intensivos y Tratamiento del Dolor, Complejo Hospitalario de la Universidad de Santiago, Santiago de Compostela, A Coruña, Spain; Grupo de Investigación del Paciente Crítico, Fundación Instituto de Investigación Sanitaria de Santiago de Compostela, Universidad de Santiago de Compostela, A Coruña, Spain. 5. Departamento de Cardiología, Hospital Universitario de San Juan, Alicante, Spain.
Abstract
INTRODUCTION AND OBJECTIVES: Coronary heart disease is the leading cause of heart failure (HF). The aim of this study was to assess the risk of readmission for HF in patients with acute coronary syndrome without previous HF or left ventricular dysfunction. METHODS: Prospective study of consecutive patients admitted for acute coronary syndrome in 2 institutions. Risk factors for HF were analyzed by competing risk regression, taking all-cause mortality as a competing event. RESULTS: We included 5962 patients and 567 (9.5%) experienced at least 1 hospital readmission for acute HF. Median follow-up was 63 months and median time to HF readmission was 27.1 months. The cumulative incidence of HF was higher than mortality in the first 7 years after hospital discharge. A higher risk of HF readmission was associated with age, diabetes, previous coronary heart disease, GRACE score> 140, peripheral arterial disease, renal dysfunction, hypertension and atrial fibrillation; a lower risk was associated with optimal medical treatment. The incidence of HF in the first year of follow-up was 2.73% and no protective variables were found. A simple HF risk score predicted HF readmissions risk. CONCLUSIONS: One out of 10 patients discharged after an acute coronary syndrome without previous HF or left ventricular dysfunction had new-onset HF and the risk was higher than the risk of mortality. A simple clinical score can estimate individual risk of HF readmission even in patients without previous HF or left ventricular dysfunction.
INTRODUCTION AND OBJECTIVES:Coronary heart disease is the leading cause of heart failure (HF). The aim of this study was to assess the risk of readmission for HF in patients with acute coronary syndrome without previous HF or left ventricular dysfunction. METHODS: Prospective study of consecutive patients admitted for acute coronary syndrome in 2 institutions. Risk factors for HF were analyzed by competing risk regression, taking all-cause mortality as a competing event. RESULTS: We included 5962 patients and 567 (9.5%) experienced at least 1 hospital readmission for acute HF. Median follow-up was 63 months and median time to HF readmission was 27.1 months. The cumulative incidence of HF was higher than mortality in the first 7 years after hospital discharge. A higher risk of HF readmission was associated with age, diabetes, previous coronary heart disease, GRACE score> 140, peripheral arterial disease, renal dysfunction, hypertension and atrial fibrillation; a lower risk was associated with optimal medical treatment. The incidence of HF in the first year of follow-up was 2.73% and no protective variables were found. A simple HF risk score predicted HF readmissions risk. CONCLUSIONS: One out of 10 patients discharged after an acute coronary syndrome without previous HF or left ventricular dysfunction had new-onset HF and the risk was higher than the risk of mortality. A simple clinical score can estimate individual risk of HF readmission even in patients without previous HF or left ventricular dysfunction.
Authors: Julija Gecaite-Stonciene; Julius Burkauskas; Adomas Bunevicius; Vesta Steibliene; Jurate Macijauskiene; Julija Brozaitiene; Narseta Mickuviene; Nijole Kazukauskiene Journal: Front Psychol Date: 2022-02-04
Authors: Carlos Escobar; Beatriz Palacios; Luis Varela; Martín Gutiérrez; Mai Duong; Hungta Chen; Nahila Justo; Javier Cid-Ruzafa; Ignacio Hernández; Phillip R Hunt; Juan F Delgado Journal: J Clin Med Date: 2022-09-02 Impact factor: 4.964