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    Impact of concomitant heart failure on outcomes in patients undergoing percutaneous coronary interventions: Analysis of the Melbourne Interventional Group registry

    Access Status
    Open access via publisher
    Authors
    Lu, K.
    Yan, B.
    Ajani, A.
    Wilson, W.
    Duffy, S.
    Gurvitch, R.
    Clark, D.
    Brennan, A.
    Reid, Christopher
    Andrianopoulos, N.
    Krum, H.
    Date
    2011
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Lu, K. and Yan, B. and Ajani, A. and Wilson, W. and Duffy, S. and Gurvitch, R. and Clark, D. et al. 2011. Impact of concomitant heart failure on outcomes in patients undergoing percutaneous coronary interventions: Analysis of the Melbourne Interventional Group registry. European Journal of Heart Failure. 13 (4): pp. 416-422.
    Source Title
    European Journal of Heart Failure
    DOI
    10.1093/eurjhf/hfr003
    ISSN
    1388-9842
    School
    Department of Health Policy and Management
    URI
    http://hdl.handle.net/20.500.11937/7928
    Collection
    • Curtin Research Publications
    Abstract

    AimsThe presence of heart failure (HF) is an established risk factor for adverse outcomes in patients undergoing percutaneous coronary intervention (PCI). The aim of this study was to determine the prevalence and impact of concomitant HF on major outcomes in contemporary PCI practice.Methods and resultsWe analysed 5006 consecutive PCIs (20042006) enrolled in the Melbourne Interventional Group registry. Baseline characteristics, in-hospital, 30-day, and 12-month outcomes of patients with a history of HF (n 189, 3.8) were compared with patients without HF (n 4817, 96.2). Patients with a history of HF were older (mean age 72.9 ± 9.8 vs. 64.3 ± 12 years, P< 0.01) and had higher rates of diabetes (37.0 vs. 23.5, P< 0.01), renal dysfunction (Cr >200 µmol/L; 16.5 vs. 3.9, P< 0.01), multi-vessel disease (79.8 vs. 58.7, P< 0.01), and presentation with cardiogenic shock (4.8 vs. 2.1, P 0.02). At 12 months, patients with HF had higher overall mortality (13.7 vs. 3.5, P< 0.01) and rates of HF admission (10.4 vs. 2.0, P< 0.01). Independent predictors of recurrent HF admission included history of HF [odds ratio (OR) 2.2, 95 confidence interval (CI) 1.24.2, P< 0.01] and renal dysfunction (OR 2.5, 95 CI 1.44.4, P< 0.01). At 12 months, patients with HF had lower rates of statin (73.9 vs. 89.2, P< 0.01) and beta-blocker use (55.6 vs. 59.0, P< 0.01). Angiotensin-converting enzyme-inhibitor/angiotensin receptor blocker use was also relatively low in HF patients (79.6). ConclusionWhile the overall incidence of HF in patients undergoing PCI is low, underutilization of HF therapies may contribute to an increased likelihood of subsequent re-admission and increased mortality. © 2010 The Author.

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