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Revascularization in patients with heart failure.

Ross T Tsuyuki1, Fiona M Shrive, P Diane Galbraith

  • 1Division of Cardiology, University of Alberta, Edmonton, Alta.

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
|August 16, 2006
PubMed
Summary

Coronary revascularization significantly improves survival in patients with heart failure and coronary artery disease. This procedure reduces 1-year mortality and enhances long-term survival rates, supporting current guidelines.

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Area of Science:

  • Cardiology
  • Clinical Outcomes Research

Background:

  • Practice guidelines recommend coronary revascularization for heart failure patients, but supporting evidence is limited.
  • The study aimed to assess the association between coronary revascularization and survival in heart failure patients.

Purpose of the Study:

  • To determine the impact of coronary revascularization on survival rates in patients with heart failure and coronary artery disease.

Main Methods:

  • Utilized data from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) database.
  • Included patients with heart failure and coronary artery disease, excluding those with normal arteries or prior bypass surgery.
  • Employed survival curve analysis with corrected group prognosis and propensity scores for adjustment.

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Main Results:

  • 2538 patients underwent revascularization, and 1690 did not.
  • 1-year mortality was 11.8% with revascularization versus 21.6% without.
  • Adjusted survival curves showed significantly improved survival with revascularization up to 7 years (HR 0.50).

Conclusions:

  • Coronary revascularization is associated with improved survival in heart failure patients with coronary disease.
  • Findings support existing practice guidelines recommending revascularization for this patient group.