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New-onset heart failure after acute coronary syndrome in patients without heart failure or left ventricular dysfunction.

Authors
  • Cordero, Alberto1
  • Rodríguez-Mañero, Moisés2
  • Bertomeu-González, Vicente3
  • García-Acuña, José M2
  • Baluja, Aurora4
  • Agra-Bermejo, Rosa2
  • Álvarez-Álvarez, Belén2
  • Cid, Belén2
  • Zuazola, Pilar5
  • González-Juanatey, José R2
  • 1 Departamento de Cardiología, Hospital Universitario de San Juan, Alicante, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain. Electronic address: [email protected] , (Spain)
  • 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. , (Spain)
  • 3 Departamento de Cardiología, Hospital Universitario de San Juan, Alicante, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain. , (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. , (Spain)
  • 5 Departamento de Cardiología, Hospital Universitario de San Juan, Alicante, Spain. , (Spain)
Type
Published Article
Journal
Revista espanola de cardiologia (English ed.)
Publication Date
Jun 01, 2021
Volume
74
Issue
6
Pages
494–501
Identifiers
DOI: 10.1016/j.rec.2020.03.011
PMID: 32448726
Source
Medline
Keywords
Language
Spanish
License
Unknown

Abstract

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. 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. 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. 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. Copyright © 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

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