Predictive factors of heart failure in acute coronary syndrome: Institutional cross-sectional study

Heart failure complicating acute coronary syndrome (ACS) remains a challenge because it is associated with a high risk of mortality at 1 year.Our objective is to highlight the factors frequently associated with heart failure following an ACS and thus deduce the predictive factors for the occurrence of heart failure.

ACS patients who were managed between 01/01/2021 to 06/30/2021 at the authors' institution were included retrospectively in the analysis.

One hundred twenty-one patients (121) included. Eighty-seven were males (72%), and the mean age was 59.4 ± 8.8. Most patients were smokers (58.7%),40% were diabetic, and 40.5% were hypertensive. Dyslipidemia was found in 37.2% of cases. 75% of patients were admitted for STEMI, and 25% for NSTEMI. The majority of patients (67.5%) were admitted out of time. The anterior electrical territory was found as a factor in the occurrence of heart failure (OR = 5.47, 95% CI (2.16-15.26), P = 0.0005). Among the patients who presented a heart failure, 64% had an LVEF <40%, and only 3% with an LVEF >50% (P < 0.001). Also, 76% had a Wall Motion Index Score (WMSI) of 1.5 (P < 0.001). Angioplasty was the treatment of choice in 65%, aortocoronary bypass in 7% of cases, and medical treatment alone, associated or not with ischemia/viability tests in 28% of cases. Patients admitted out of time (>12 h) were found to be a factor in the occurrence of HF (OR = 3.31,95% CI (1.21-10,60), P = 0.02). The outcome was favorable in 93% of cases. We observed 9 cases of complications including 4 deaths from cardiogenic, septic, and hemorrhagic shock.

This study allows us to identify patients at risk of developing heart failure and patients with a more reserved prognosis. Besides, our findings will allow our peers and colleagues to be able to detect early these factors and optimize adequate management to avoid heart failure.