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Coronary artery disease and outcome in acute congestive heart failure

L Purek1, K Laule-Kilian, A Christ

  • 1Department of Internal Medicine, University of Basel, University Hospital, Basel, Switzerland.

Heart (British Cardiac Society)
|September 15, 2005
PubMed

Insights

Coronary artery disease (CAD) significantly increases mortality risk in patients with acute heart failure (HF). Even with optimal treatment, those with CAD face worse outcomes and lower survival rates.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Public Health

Background:

  • Acute heart failure (HF) is a major cause of hospitalization and mortality.
  • The role of coronary artery disease (CAD) as a prognostic factor in acute HF requires further clarification.

Purpose of the Study:

  • To determine the prognostic impact of coronary artery disease (CAD) on mortality in patients presenting with acute heart failure (HF).

Main Methods:

  • Prospective cohort study involving 217 consecutive patients with acute HF.
  • Follow-up of up to three years, observing treatment, hospitalization, revascularization, and survival.
  • Cox regression analysis was used to assess the risk of death associated with CAD.

Main Results:

  • Coronary artery disease (CAD) was present in 71% of patients.
  • Patients with CAD had significantly worse initial outcomes, including higher hospitalization rates and longer discharge times.
  • CAD was associated with a significantly lower survival rate (48.7% at 720 days vs. 76.4% without CAD) and increased mortality risk (HR 2.57).

Conclusions:

  • Coronary artery disease (CAD) is a strong, independent predictor of mortality in acute heart failure (HF) patients.
  • The low utilization of coronary angiography and revascularization procedures in this population warrants further investigation.
  • Further research is needed to explore if less restrictive revascularization strategies can improve outcomes for acute HF patients with CAD.
Abstract

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