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Heart failure with preserved left ventricular systolic function among patients with non-ST-segment elevation acute coronary syndromes.

Publication ,  Journal Article
Bennett, KM; Hernandez, AF; Chen, AY; Mulgund, J; Newby, LK; Rumsfeld, JS; Hochman, JS; Hoekstra, JW; Ohman, EM; Gibler, WB; Roe, MT; Peterson, ED
Published in: Am J Cardiol
May 15, 2007

Previous studies of non-ST-segment elevation acute coronary syndromes (NSTE ACSs) complicated by heart failure (HF) have focused primarily on patients with left ventricular systolic dysfunction defined by an ejection fraction (EF) <40%. Little is known about HF with preserved systolic function (EF > or =40%) in the NSTE ACS population. We identified high-risk patients with NSTE ACS (ischemic electrocardiographic changes and/or positive cardiac markers) from the CRUSADE quality improvement initiative who had an EF recorded and who had information on HF status. Management and outcomes were analyzed and compared based on the presence or absence of HF and whether left ventricular EF was > or =40%. Of 94,558 patients with NSTE ACS, 21,561 (22.8%) presented with signs of HF, and most had HF with preserved systolic function (n = 11,860, 55%). Mortality rates were 10.7% for HF/systolic dysfunction, 5.8% for HF/preserved systolic function, 5.7% for no HF/systolic dysfunction, and 1.5% for no HF/preserved systolic function. Use of guideline-recommended medical therapies and interventions was frequently significantly lower in those with HF regardless of EF compared with those without HF, except for use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. In conclusion, NSTE ACS complicated by HF with preserved systolic function is common and associated with a 2.3-fold higher mortality compared with NSTE ACS without HF or systolic dysfunction. Guideline-recommended therapies and interventions are under-utilized in patients with NSTE ACS and HF, with and without preserved systolic function, compared with those without HF.

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

May 15, 2007

Volume

99

Issue

10

Start / End Page

1351 / 1356

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Ventricular Dysfunction, Left
  • United States
  • Troponin T
  • Troponin I
  • Treatment Outcome
  • Systole
  • Syndrome
  • Survival Analysis
  • Stroke Volume
 

Citation

APA
Chicago
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MLA
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Bennett, K. M., Hernandez, A. F., Chen, A. Y., Mulgund, J., Newby, L. K., Rumsfeld, J. S., … Peterson, E. D. (2007). Heart failure with preserved left ventricular systolic function among patients with non-ST-segment elevation acute coronary syndromes. Am J Cardiol, 99(10), 1351–1356. https://doi.org/10.1016/j.amjcard.2006.12.057
Bennett, Kyla M., Adrian F. Hernandez, Anita Y. Chen, Jyotsna Mulgund, L Kristin Newby, John S. Rumsfeld, Judith S. Hochman, et al. “Heart failure with preserved left ventricular systolic function among patients with non-ST-segment elevation acute coronary syndromes.Am J Cardiol 99, no. 10 (May 15, 2007): 1351–56. https://doi.org/10.1016/j.amjcard.2006.12.057.
Bennett KM, Hernandez AF, Chen AY, Mulgund J, Newby LK, Rumsfeld JS, et al. Heart failure with preserved left ventricular systolic function among patients with non-ST-segment elevation acute coronary syndromes. Am J Cardiol. 2007 May 15;99(10):1351–6.
Bennett, Kyla M., et al. “Heart failure with preserved left ventricular systolic function among patients with non-ST-segment elevation acute coronary syndromes.Am J Cardiol, vol. 99, no. 10, May 2007, pp. 1351–56. Pubmed, doi:10.1016/j.amjcard.2006.12.057.
Bennett KM, Hernandez AF, Chen AY, Mulgund J, Newby LK, Rumsfeld JS, Hochman JS, Hoekstra JW, Ohman EM, Gibler WB, Roe MT, Peterson ED. Heart failure with preserved left ventricular systolic function among patients with non-ST-segment elevation acute coronary syndromes. Am J Cardiol. 2007 May 15;99(10):1351–1356.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

May 15, 2007

Volume

99

Issue

10

Start / End Page

1351 / 1356

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Ventricular Dysfunction, Left
  • United States
  • Troponin T
  • Troponin I
  • Treatment Outcome
  • Systole
  • Syndrome
  • Survival Analysis
  • Stroke Volume