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Published on: April 17, 2021

Acute coronary syndromes complicated by symptomatic and asymptomatic heart failure: does current treatment comply

Moti Haim1, Alexander Battler, Solomon Behar

  • 1Cardiology Department, Rabin Medical Center, Petah-Tikva, Israel.

American Heart Journal
|May 8, 2004
PubMed

Insights

Patients with acute coronary syndromes (ACS) and heart failure (HF) face higher mortality risks. While guideline-recommended ACE inhibitors and beta-blockers were used, lower rates of angiography and revascularization in HF patients may worsen outcomes.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • Patients with acute coronary syndromes (ACS) complicated by heart failure (HF) exhibit elevated mortality.
  • Current guidelines recommend angiotensin-converting enzyme inhibitors (ACEI), beta-blockers, and early invasive risk stratification for these patients.

Purpose of the Study:

  • To evaluate adherence to established treatment guidelines for patients diagnosed with ACS and complicated by HF.
  • The study focused on patient populations within the Europe and Mediterranean regions.

Main Methods:

  • The Euro-Heart ACS survey included 10,484 patients, with 9587 analyzed for HF status.
  • Patients were categorized based on the presence or development of symptomatic HF during hospitalization.
  • Outcomes were compared between patients with and without HF, considering cardiovascular risk factors and treatment modalities.

Main Results:

  • Symptomatic HF was present in 26% of ACS patients; these patients were older and had more cardiovascular risk factors.
  • ACEI use was higher in HF patients (75% vs. 56%), but beta-blocker use was lower (75% vs. 82%).
  • Coronary angiography (42% vs. 57%) and revascularization (32% vs. 42%) rates were significantly lower in HF patients, correlating with higher adjusted in-hospital mortality risk.

Conclusions:

  • ACS patients with HF face significantly increased mortality risks.
  • While ACEI and beta-blocker use showed adherence to recommendations, lower rates of invasive procedures like coronary angiography and revascularization in HF patients may contribute to poorer outcomes.
Abstract

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