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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
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Coronary risk stratification of patients with newly diagnosed heart failure

Rasmus Bo Hasselbalch1, Mia Pries-Heje1, Thomas Engstrøm2

  • 1Department of Cardiology, Herlev og Gentofte Hospital, Herlev, Denmark.

Open Heart
|November 2, 2019
PubMed

Insights

A new CT-HF score helps identify patients with heart failure (HF) who have a low risk of coronary artery disease (CAD). This score can guide decisions on using non-invasive multislice CT (MSCT) instead of coronary angiography (CAG).

Area of Science:

  • Cardiology
  • Medical Imaging
  • Risk Stratification

Background:

  • Coronary artery disease (CAD) is common in patients with newly diagnosed heart failure (HF).
  • Multislice CT (MSCT) is a non-invasive imaging technique for assessing CAD risk.
  • Defining patients suitable for MSCT over coronary angiography (CAG) remains challenging.

Purpose of the Study:

  • To develop a simple clinical risk score to identify patients with newly diagnosed heart failure (HF) at low pretest risk for coronary artery disease (CAD).
  • To establish a tool for selecting appropriate patients for non-invasive multislice CT (MSCT) as a gatekeeper to coronary angiography (CAG).

Main Methods:

  • Retrospective analysis of 2171 patients with newly diagnosed HF undergoing CAG.
  • Development of the CT-HF score using multivariable logistic regression to identify CAD predictors.
  • Validation of the CT-HF score in an independent cohort of 2795 patients.

Main Results:

  • The CT-HF score identified 61% of patients as having a low risk (15%) of significant CAD.
  • Extracardiac arteriopathy was the strongest predictor (OR 2.84), followed by male sex, smoking, hyperlipidaemia, diabetes, angina, and age.
  • Utilizing the score could lead to estimated savings of 15% in costs and 21% in radiation exposure.

Conclusions:

  • A simple clinical risk score effectively identifies HF patients with low CAD risk.
  • These patients may benefit from MSCT as a preferred initial diagnostic test over CAG.
  • The CT-HF score aids in optimizing diagnostic pathways for CAD in HF patients.
Abstract

Keywords:
coronary artery diseaseheartfailure

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