Author + information
- Sean van Diepen,
- Anita Chen,
- Tracy Wang,
- Karen Alexander,
- Justin Ezekowitz,
- Paul Armstrong,
- Eric Peterson and
- Matthew Roe
Symptomatic heart failure (HF) and reduced left ventricular ejection fraction (EF) are both associated with increased short-term mortality in patients with nonST-segment elevation myocardial infarction (NSTEMI), but long-term outcomes associated with the development of clinical HF in patients with and without a reduced EF are uncertain.
We analyzed a total of 26,291 NSTEMI patients ≥65 years in the CRUSADE Registry with linked CMS longitudinal data who survived to hospital discharge and had a measured EF. We described in-hospital treatment differences and 1-year outcomes among patients stratified by the development of symptomatic HF and measured EF values (≥40 and <40%).
Significant differences in patient characteristics, in-hospital procedures, hospital readmission, and 1-year mortality rates were observed in patients stratified by EF and the development of symptomatic HF (Table). Compared with patients without HF and an EF ≥40%, the adjusted 1-year mortality risks were higher among patients with EF <40% without HF (hazard ratio [HR] 1.82: 95% confidence interval [Cl], 1.652.00), with an EF ≥40% and HF (HR 1.81: 95% Cl, 1.661.98), and with EF <40% with HF (HR 2.29: 95% Cl, 2.062.53).
The development of symptomatic HF and reduced EF are both associated with an increased risk of long-term hospital re-admission and mortality in NSTEMI patients. These data provide opportunities for more aggressive secondary prevention in this high-risk population.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Epidemiology, Risk Modeling and Prediction of Outcomes in Heart Failure
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1308-297
- 2013 American College of Cardiology Foundation