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Heart failure patients with a previous coronary revascularization: results from the ESC-HF Registry
Agata Tymińska1, Paweł Balsam2, Krzysztof Ozierański1
11st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
Insights
Heart failure patients who underwent coronary revascularization (PCI/CABG) had similar mortality but a higher risk of death or hospitalization at 12 months compared to those without revascularization.
Area of Science:
- Cardiology
- Heart Failure Research
- Interventional Cardiology
Background:
- Coronary revascularization procedures, including percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), are frequently performed in patients with heart failure (HF).
- Understanding the outcomes of these patients is crucial for optimizing treatment strategies.
Purpose of the Study:
- To assess the clinical characteristics and in-hospital and long-term outcomes of patients hospitalized for heart failure.
- To compare outcomes between HF patients with and without prior PCI or CABG.
Main Methods:
- The study analyzed data from 649 inpatients in the ESC-HF Pilot Survey.
- Primary endpoint was all-cause death; secondary endpoint included all-cause death or HF hospitalization at one year.
- In-hospital mortality was also evaluated.
Main Results:
- Revascularized patients (PCI/CABG) were more likely to have comorbidities like hypertension and diabetes.
- While in-hospital mortality was higher in non-PCI/CABG patients, 12-month outcomes showed revascularized patients had a similar risk of death but a higher risk of death or HF hospitalization.
- Independent predictors for mortality and hospitalization varied between groups, with serum sodium and heart rate at discharge being significant in both or non-revascularized groups, respectively.
Conclusions:
- Heart failure patients who underwent revascularization had comparable mortality rates but an increased risk of death or hospitalization at 12 months compared to non-revascularized patients.
- Revascularized patients presented with more comorbidities, whereas non-revascularized patients experienced higher rates of cardiogenic shock and in-hospital mortality.
Background:
Coronary revascularization is common in heart failure (HF).
Aims:
Clinical characteristic and assessment of in-hospital and long-term outcomes in patients hospitalized for HF with or without a previous percutaneous coronary intervention (PCI) or a coronary artery bypass grafting (CABG).
Methods:
The primary endpoint (PE) (all-cause death) and the secondary endpoint (SE) (all-cause death or hospitalization for HF-worsening) were assessed at one-year in 649 inpatients of the ESC-HF Pilot Survey. Additionally, occurrence of death during index hospitalization was evaluated.
Results:
PCI/CABG-patients (32.7%) were more frequently male, smokers, had myocardial infarction, hypertension (HT), peripheral artery disease and diabetes. The non-PCI/CABG-patients more often had a cardiogenic shock and died in-hospital. The PE occurred in 33 of the 212 PCI/CABG-patients (15.6%) and in 56 of the 437 non-PCI/CABG-patients (12.8%; P=0.3). The SE occurred in 82 of the 170 PCI/CABG-patients (48.2%) and in 122 of the 346 non-PCI/CABG-patients (35.3%; P=0.01). Independent predictors of the PE in the PCI/CABG-patients were: lower left ventricular ejection fraction, use of antiplatelets; in the non-PCI/CABG-patients were: age, ACS at admission. Independent predictors of the SE in the PCI/CABG-patients were: diabetes, NYHA (New York Heart Association) class at admission, HT; in the non-PCI/CABG-patients were: NYHA class, haemoglobin at admission. Serum sodium concentration at admission was a predictor of the PE and the SE in both groups. Heart rate at discharge was a predictor of the PE and the SE in the non-PCI/CABG patients.
Conclusions:
The revascularized HF patients had a similar mortality and higher risk of death or hospitalizationsat 12 months compared with the non-PCI/CABG-patients. The revascularized patients had more comorbidities, while the non-PCI/CABG-patients had a higher incidence of cardiogenic shock and in-hospital mortality.
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