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Prognostic significance of obstructive coronary artery disease in patients admitted with acute decompensated heart failure: the ARIC study community surveillance.

Publication ,  Conference
Chunawala, ZS; Qamar, A; Arora, S; Pandey, A; Fudim, M; Vaduganathan, M; Mentz, RJ; Bhatt, DL; Caughey, MC
Published in: Eur J Heart Fail
November 2022

AIMS: We aimed to investigate the impact of obstructive coronary artery disease (CAD) in patients with acute decompensated heart failure (ADHF), and examine potential differences in prognostic utility for heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF). METHODS AND RESULTS: The Atherosclerosis Risk in Communities study conducted hospital surveillance of ADHF from 2005 to 2014. Obstructive CAD was defined as ≥50% or ≥75% stenosis, respectively, for the left main and other major epicardial arteries. Adjusted associations between obstructive CAD and 30-, 60-, and 90-day mortality were analysed. A total of 934 (4146 weighted) patients admitted with ADHF (mean age 72 years, 46% women, 30% Black, 30% HFpEF) had available angiography (61% performed in hospital). Obstructive CAD was more prevalent with HFrEF than HFpEF, whether at the left main (15% vs. 11%), left anterior descending (LAD) (48% vs. 30%), left circumflex (37% vs. 32%), right coronary (42% vs. 32%), or multiple coronary arteries (45% vs. 33%). In-hospital revascularization was performed in 25% and 22% of patients with HFrEF and HFpEF, respectively. Obstructive CAD was associated with higher adjusted mortality, particularly with left main or LAD involvement, and had a more pronounced association with 90-day mortality in HFrEF (odds ratio [OR] 2.77; 95% confidence interval [CI] 1.53-5.02) than HFpEF (OR 0.94; 95% CI 0.36-2.41) (p-interaction = 0.05). CONCLUSION: Patients hospitalized with ADHF and coexisting obstructive CAD have higher short-term mortality, warranting the need for effective interventions and secondary prevention.

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Published In

Eur J Heart Fail

DOI

EISSN

1879-0844

Publication Date

November 2022

Volume

24

Issue

11

Start / End Page

2140 / 2149

Location

England

Related Subject Headings

  • Stroke Volume
  • Prognosis
  • Male
  • Humans
  • Heart Failure
  • Female
  • Coronary Artery Disease
  • Cardiovascular System & Hematology
  • Aged
  • 3201 Cardiovascular medicine and haematology
 

Citation

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Chunawala, Z. S., Qamar, A., Arora, S., Pandey, A., Fudim, M., Vaduganathan, M., … Caughey, M. C. (2022). Prognostic significance of obstructive coronary artery disease in patients admitted with acute decompensated heart failure: the ARIC study community surveillance. In Eur J Heart Fail (Vol. 24, pp. 2140–2149). England. https://doi.org/10.1002/ejhf.2617
Chunawala, Zainali S., Arman Qamar, Sameer Arora, Ambarish Pandey, Marat Fudim, Muthiah Vaduganathan, Robert J. Mentz, Deepak L. Bhatt, and Melissa C. Caughey. “Prognostic significance of obstructive coronary artery disease in patients admitted with acute decompensated heart failure: the ARIC study community surveillance.” In Eur J Heart Fail, 24:2140–49, 2022. https://doi.org/10.1002/ejhf.2617.
Chunawala ZS, Qamar A, Arora S, Pandey A, Fudim M, Vaduganathan M, et al. Prognostic significance of obstructive coronary artery disease in patients admitted with acute decompensated heart failure: the ARIC study community surveillance. In: Eur J Heart Fail. 2022. p. 2140–9.
Chunawala, Zainali S., et al. “Prognostic significance of obstructive coronary artery disease in patients admitted with acute decompensated heart failure: the ARIC study community surveillance.Eur J Heart Fail, vol. 24, no. 11, 2022, pp. 2140–49. Pubmed, doi:10.1002/ejhf.2617.
Chunawala ZS, Qamar A, Arora S, Pandey A, Fudim M, Vaduganathan M, Mentz RJ, Bhatt DL, Caughey MC. Prognostic significance of obstructive coronary artery disease in patients admitted with acute decompensated heart failure: the ARIC study community surveillance. Eur J Heart Fail. 2022. p. 2140–2149.
Journal cover image

Published In

Eur J Heart Fail

DOI

EISSN

1879-0844

Publication Date

November 2022

Volume

24

Issue

11

Start / End Page

2140 / 2149

Location

England

Related Subject Headings

  • Stroke Volume
  • Prognosis
  • Male
  • Humans
  • Heart Failure
  • Female
  • Coronary Artery Disease
  • Cardiovascular System & Hematology
  • Aged
  • 3201 Cardiovascular medicine and haematology