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Management and outcomes following an acute coronary event in patients with chronic heart failure 1999–2007

Identifieur interne : 002543 ( Istex/Corpus ); précédent : 002542; suivant : 002544

Management and outcomes following an acute coronary event in patients with chronic heart failure 1999–2007

Auteurs : Isuru Ranasinghe ; Chris Naoum ; Bernadette Aliprandi-Costa ; Andrew P. Sindone ; P. Gabriel Steg ; John Elliott ; Bruce Mcgarity ; Jeffrey Lefkovits ; David Brieger

Source :

RBID : ISTEX:C90654708B94AECAB04DD423F7766C284F587338

English descriptors

Abstract

The outcome of patients with chronic heart failure (CHF) following an ischaemic event is poorly understood. We evaluated the management and outcomes of CHF patients presenting with an acute coronary syndrome (ACS) and explored changes in outcomes over time.

Url:
DOI: 10.1093/eurjhf/hfs041

Links to Exploration step

ISTEX:C90654708B94AECAB04DD423F7766C284F587338

Le document en format XML

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<div type="abstract">The outcome of patients with chronic heart failure (CHF) following an ischaemic event is poorly understood. We evaluated the management and outcomes of CHF patients presenting with an acute coronary syndrome (ACS) and explored changes in outcomes over time.</div>
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<p>The outcome of patients with chronic heart failure (CHF) following an ischaemic event is poorly understood. We evaluated the management and outcomes of CHF patients presenting with an acute coronary syndrome (ACS) and explored changes in outcomes over time.</p>
Method and results
<p>A total of 5556 patients enrolled in the Australia–New Zealand population of the Global Registry of Acute Coronary Events (GRACE) between 1999 and 2007 were included. Patients with CHF (
<hi rend="italic">n</hi>
= 609) were compared with those without CHF (
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Conclusions
<p>Acute coronary syndrome patients with pre‐existing CHF are a very high risk group and carry a disproportionate mortality burden. Encouragingly, there was a marked temporal improvement in outcomes over a 9 year period with an increase in evidence‐based treatments and secondary preventative measures.</p>
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<namePart type="family">Steg</namePart>
<affiliation>INSERM U‐698, Hôpital Bichat, and Universite Paris 7, Paris, France</affiliation>
<role>
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</name>
<name type="personal">
<namePart type="given">John</namePart>
<namePart type="family">Elliott</namePart>
<affiliation>Christchurch Hospital, Christchurch, New Zealand</affiliation>
<role>
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</role>
</name>
<name type="personal">
<namePart type="given">Bruce</namePart>
<namePart type="family">McGarity</namePart>
<affiliation>Bathurst Base Hospital, NSW, Bathurst, Australia</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Jeffrey</namePart>
<namePart type="family">Lefkovits</namePart>
<affiliation>Royal Melbourne Hospital, Victoria, Melbourne, Australia</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">David</namePart>
<namePart type="family">Brieger</namePart>
<affiliation>Concord Repatriation General Hospital and The University of Sydney, NSW, Sydney, Australia</affiliation>
<affiliation>E-mail: davidb@email.cs.nsw.gov.au</affiliation>
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<namePart>on behalf of the Australia–New Zealand GRACE</namePart>
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<publisher>Blackwell Publishing Ltd</publisher>
<dateIssued encoding="w3cdtf">2012-05</dateIssued>
<dateCreated encoding="w3cdtf">2014-02-06</dateCreated>
<dateCaptured encoding="w3cdtf">2011-12-28</dateCaptured>
<dateValid encoding="w3cdtf">2012-03-02</dateValid>
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<abstract>The outcome of patients with chronic heart failure (CHF) following an ischaemic event is poorly understood. We evaluated the management and outcomes of CHF patients presenting with an acute coronary syndrome (ACS) and explored changes in outcomes over time.</abstract>
<abstract>A total of 5556 patients enrolled in the Australia–New Zealand population of the Global Registry of Acute Coronary Events (GRACE) between 1999 and 2007 were included. Patients with CHF (n = 609) were compared with those without CHF (n = 4947). Patients with CHF were on average 10 years older, were more likely to be female, had more co‐morbidities and cardiac risk factors, and were more likely to have a prior history of angina, myocardial infarction, and revascularization by coronary artery bypass graft (CABG) when compared with those without CHF. CHF was associated with a substantial increase in in‐hospital renal failure [odds ratio (OR) 1.76, 95% confidence interval (CI) 1.15–2.71], readmission post‐discharge (OR 1.47, 95% CI 1.17–1.90), and 6‐month mortality (OR 2.25, 95% CI 1.55–3.27). Over the 9 year study period, in‐hospital and 6 month mortality in those with CHF declined by absolute rates of 7.5% and 14%, respectively. This was temporally associated with an increase in prescription of thienopyridines, beta‐blockers, statins, and angiotensin II receptor blockers, increased rates of coronary angiography, and 31.8% absolute increase in referral rates for cardiac rehabilitation.</abstract>
<abstract>Acute coronary syndrome patients with pre‐existing CHF are a very high risk group and carry a disproportionate mortality burden. Encouragingly, there was a marked temporal improvement in outcomes over a 9 year period with an increase in evidence‐based treatments and secondary preventative measures.</abstract>
<subject>
<genre>keywords</genre>
<topic>acute coronary syndromes</topic>
<topic>heart failure</topic>
<topic>epidemiology</topic>
<topic>outcomes research</topic>
</subject>
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<title>European Journal of Heart Failure</title>
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<title>European Journal of Heart Failure</title>
</titleInfo>
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<subject>
<genre>article-category</genre>
<topic>Epidemiology</topic>
</subject>
<identifier type="ISSN">1388-9842</identifier>
<identifier type="eISSN">1879-0844</identifier>
<identifier type="DOI">10.1002/(ISSN)1879-0844</identifier>
<identifier type="PublisherID">EJHF</identifier>
<part>
<date>2012</date>
<detail type="volume">
<caption>vol.</caption>
<number>14</number>
</detail>
<detail type="issue">
<caption>no.</caption>
<number>5</number>
</detail>
<extent unit="pages">
<start>464</start>
<end>472</end>
<total>9</total>
</extent>
</part>
</relatedItem>
<identifier type="istex">C90654708B94AECAB04DD423F7766C284F587338</identifier>
<identifier type="ark">ark:/67375/WNG-HXPCHNCJ-B</identifier>
<identifier type="DOI">10.1093/eurjhf/hfs041</identifier>
<identifier type="ArticleID">EJHFHFS041</identifier>
<accessCondition type="use and reproduction" contentType="copyright">© 2012 European Society of CardiologyPublished on behalf of the European Society of Cardiology. All rights reserved. © 2012 the Authors</accessCondition>
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