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Prognostic role of coronary angiography and revascularization in patients firstly admitted for heart failure in Italy.
D'Errigo, Paola; De Luca, Leonardo; Rosato, Stefano; Giordani, Barbara; Badoni, Gabriella; Oliva, Fabrizio; Baglio, Giovanni.
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  • D'Errigo P; National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy.
  • De Luca L; Department of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, A.O. San Camillo-Forlanini, Rome, Italy.
  • Rosato S; National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy. Electronic address: stefano.rosato@iss.it.
  • Giordani B; Italian National Agency for Regional Healthcare Services, Rome, Italy.
  • Badoni G; National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy.
  • Oliva F; Cardiovascular Department(,) Division of Cardiology, "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy.
  • Baglio G; Italian National Agency for Regional Healthcare Services, Rome, Italy.
Int J Cardiol ; 413: 132369, 2024 Oct 15.
Article en En | MEDLINE | ID: mdl-39053813
ABSTRACT

BACKGROUND:

Coronary artery disease (CAD) is a common underlying cause of de novo heart failure (HF) and is associated with poor outcome despite advances in medical therapy. There are no data clearly supporting coronary angiogram (CVG) and revascularization in this setting.

METHODS:

We analysed a nationwide, comprehensive, and universal administrative database of consecutive patients for the first time admitted in hospital for HF, without a history of CAD, who survived 30 days after index admission from 2015 to 2019 in Italy. Enrolled patients were classified into subjects who did not undergo CVG; those who underwent CVG without coronary revascularization; those who underwent percutaneous coronary intervention (PCI); and those who underwent coronary artery bypass grafting (CABG).

RESULTS:

During the study period, 342,090 patients were hospitalized for the first time due to HF and survived 30 days after admission, in Italy. Among them, 30,806 (9.0%) patients underwent CVG without undergoing coronary revascularization, 5855 (1.7%) underwent PCI and 1594 (0.5%) underwent CABG. After adjusting for age, gender and comorbidity, the hazard ratio (HR) for 1-year all-cause mortality in patients undergoing CVG vs no CVG were 0.56 (p < 0.0001), 0.66 (p < 0.0001) and 0.83 (p = 0.020) for CVG, PCI and CABG patients, respectively. When considering the re-hospitalization for HF as the outcome, using death as a competing risk, after multiple corrections, CVG (HR = 0.80; p < 0.0001) and CABG (HR = 0.73; p < 0.0002) were protective versus No CVG, but not PCI (HR = 1.02; p = 0.642).

CONCLUSIONS:

This study provides evidence that CVG and coronary revascularization may be beneficial for patients with de novo HF.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Angiografía Coronaria / Intervención Coronaria Percutánea / Insuficiencia Cardíaca Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Angiografía Coronaria / Intervención Coronaria Percutánea / Insuficiencia Cardíaca Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Países Bajos