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Management issues for patients with coronary artery disease and heart failure
Andrew D Feingold1, David DeNofrio
1Tufts-New England Medical Center, Division of Cardiology, 750 Washington Street, Boston, MA 02111, USA.
Insights
Heart failure is a deadly disease, but new treatments are improving survival. This review examines invasive therapies for heart failure caused by coronary artery disease to find the best management strategies.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Medical Therapy
Background:
- Heart failure (HF) remains a significant cause of mortality despite survival improvements.
- An aging population and better prevention of early coronary artery disease (CAD) deaths increase HF prevalence in the US.
- HF secondary to CAD presents complex management challenges.
Purpose of the Study:
- To review the relative efficacy of various invasive therapies for heart failure in patients with coronary artery disease.
- To define optimal management strategies for this patient population.
Main Methods:
- Systematic review of clinical studies.
- Analysis of invasive treatment options for heart failure secondary to coronary artery disease.
Main Results:
- Efficacy of coronary revascularization, surgical left ventricle remodeling, internal cardiac defibrillator implantation, cardioverter resynchronization therapy, mechanical ventricular assist, and cardiac transplantation are considered.
- Evidence is synthesized to guide treatment decisions.
Conclusions:
- Optimal management requires careful consideration of multiple invasive therapies.
- Further research and clinical evaluation are needed to refine treatment algorithms for heart failure in CAD patients.
Abstract:
Despite recent favorable trends in survival, heart failure remains a highly fatal disease. Improvements in the prevention of early death from coronary artery disease, along with an aging population, have resulted in an increased prevalence for heart failure in the United States. In the management of patients with heart failure secondary to coronary artery disease, the relative efficacy of invasive therapies such as coronary revascularization, surgical left ventricle remodeling, internal cardiac defibrillator implantation, cardioverter resynchronization therapy, mechanical ventricular assist, and cardiac transplantation need to be considered. Clinical studies examining these important treatment options are reviewed in order to better define the optimal management strategy for this challenging population of patients.