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Testing for Coronary Artery Disease in Older Patients With New-Onset Heart Failure: Findings From Get With The Guidelines-Heart Failure.

Publication ,  Journal Article
O'Connor, KD; Brophy, T; Fonarow, GC; Blankstein, R; Swaminathan, RV; Xu, H; Matsouaka, RA; Albert, NM; Velazquez, EJ; Yancy, CW; Hernandez, AF ...
Published in: Circulation. Heart failure
April 2020

Current guidelines recommend evaluation for underlying heart disease and reversible conditions for patients with new-onset heart failure (HF). There are limited data on contemporary testing for coronary artery disease (CAD) in patients with new-onset HF.We performed an observational cohort study using the Get With The Guidelines-Heart Failure registry linked to Medicare claims. All patients were aged ≥65 and hospitalized for new-onset HF from 2009 to 2015. We collected left ventricular ejection fraction (LVEF), prior HF history, and in-hospital CAD testing from the registry, as well as testing for CAD using claims from 90 days before to 90 days after index HF hospitalization.Among 17 185 patients with new-onset HF, 6672 (39%) received testing for CAD, including 3997 (23%) during the index hospitalization. Testing for CAD differed by LVEF: 53% in HF with reduced EF (LVEF ≤40%), 42% in HF with borderline EF (LVEF, 41%-49%), and 31% in HF with preserved EF (LVEF ≥50%). After multivariable adjustment, patients who received testing for CAD, compared with those who did not, were younger and more likely to be male, have a smoking history, have hyperlipidemia, and have HF with reduced ejection fraction or HF with borderline ejection fraction (all P<0.05).The majority of patients hospitalized for new-onset HF did not receive testing for CAD either during the hospitalization or in the 90 days before and after. The rates of testing for CAD were higher in patients with LVEF ≤40% though remained low. These data highlight an opportunity to improve care by identifying appropriate candidates for optimal CAD medical therapy and revascularization.

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Published In

Circulation. Heart failure

DOI

EISSN

1941-3297

ISSN

1941-3289

Publication Date

April 2020

Volume

13

Issue

4

Start / End Page

e006963

Related Subject Headings

  • Ventricular Function, Left
  • United States
  • Time Factors
  • Stroke Volume
  • Risk Factors
  • Risk Assessment
  • Registries
  • Predictive Value of Tests
  • Practice Patterns, Physicians'
  • Practice Guidelines as Topic
 

Citation

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O’Connor, K. D., Brophy, T., Fonarow, G. C., Blankstein, R., Swaminathan, R. V., Xu, H., … DeVore, A. D. (2020). Testing for Coronary Artery Disease in Older Patients With New-Onset Heart Failure: Findings From Get With The Guidelines-Heart Failure. Circulation. Heart Failure, 13(4), e006963. https://doi.org/10.1161/circheartfailure.120.006963
O’Connor, Kyle D., Todd Brophy, Gregg C. Fonarow, Ron Blankstein, Rajesh V. Swaminathan, Haolin Xu, Roland A. Matsouaka, et al. “Testing for Coronary Artery Disease in Older Patients With New-Onset Heart Failure: Findings From Get With The Guidelines-Heart Failure.Circulation. Heart Failure 13, no. 4 (April 2020): e006963. https://doi.org/10.1161/circheartfailure.120.006963.
O’Connor KD, Brophy T, Fonarow GC, Blankstein R, Swaminathan RV, Xu H, et al. Testing for Coronary Artery Disease in Older Patients With New-Onset Heart Failure: Findings From Get With The Guidelines-Heart Failure. Circulation Heart failure. 2020 Apr;13(4):e006963.
O’Connor, Kyle D., et al. “Testing for Coronary Artery Disease in Older Patients With New-Onset Heart Failure: Findings From Get With The Guidelines-Heart Failure.Circulation. Heart Failure, vol. 13, no. 4, Apr. 2020, p. e006963. Epmc, doi:10.1161/circheartfailure.120.006963.
O’Connor KD, Brophy T, Fonarow GC, Blankstein R, Swaminathan RV, Xu H, Matsouaka RA, Albert NM, Velazquez EJ, Yancy CW, Heidenreich PA, Hernandez AF, DeVore AD. Testing for Coronary Artery Disease in Older Patients With New-Onset Heart Failure: Findings From Get With The Guidelines-Heart Failure. Circulation Heart failure. 2020 Apr;13(4):e006963.

Published In

Circulation. Heart failure

DOI

EISSN

1941-3297

ISSN

1941-3289

Publication Date

April 2020

Volume

13

Issue

4

Start / End Page

e006963

Related Subject Headings

  • Ventricular Function, Left
  • United States
  • Time Factors
  • Stroke Volume
  • Risk Factors
  • Risk Assessment
  • Registries
  • Predictive Value of Tests
  • Practice Patterns, Physicians'
  • Practice Guidelines as Topic