Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Steg, PG; Dabbous, OH; Feldman, LJ; Cohen-Solal, A; Aumont, MC; López-Sendón, J; Budaj, A; Goldberg, RJ; Klein, W; Anderson, FA; Global Registry of Acute Coronary Events Investigators.
Determinants and prognostic impact of heart failure complicating acute coronary syndromes: observations from the Global Registry of Acute Coronary Events (GRACE).
Circulation. 2004; 109(4):494-499
Doi: 10.1161/01.CIR.0000109691.16944.DA
[OPEN ACCESS]
Web of Science
PubMed
FullText
FullText_MUG
- Authors Med Uni Graz:
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- BACKGROUND: Few data are available on the impact of heart failure (HF) across all types of acute coronary syndromes (ACS). METHODS AND RESULTS: The Global Registry of Acute Coronary Events (GRACE) is a prospective study of patients hospitalized with ACS. Data from 16 166 patients were analyzed: 13 707 patients without prior HF or cardiogenic shock at presentation were identified. Of these, 1778 (13%) had an admission diagnosis of HF (Killip class II or III). HF on admission was associated with a marked increase in mortality rates during hospitalization (12.0% versus 2.9% [with versus without HF], P<0.0001) and at 6 months after discharge (8.5% versus 2.8%, P<0.0001). Of note, HF increased mortality rates in patients with unstable angina (defined as ACS with normal biochemical markers of necrosis; mortality rates: 6.7% with versus 1.6% without HF at admission, P<0.0001). By logistic regression analysis, admission HF was an independent predictor of hospital death (odds ratio, 2.2; P<0.0001). Admission HF was associated with longer hospital stay and higher readmission rates. Patients with HF had lower rates of catheterization and percutaneous cardiac intervention, and fewer received beta-blockers and statins. Hospital development of HF (versus HF on presentation) was associated with an even higher in-hospital mortality rate (17.8% versus 12.0%, P<0.0001). In patients with HF, in-hospital revascularization was associated with lower 6-month death rates (14.0% versus 23.7%, P<0.0001; adjusted hazard ratio, 0.5; 95% CI, 0.37 to 0.68, P<0.0001). CONCLUSIONS: In this observational registry, heart failure was associated with reduced hospital and 6-month survival across all ACS subsets, including patients with normal markers of necrosis. More aggressive treatment of these patients may be warranted to improve prognosis.
- Find related publications in this database (using NLM MeSH Indexing)
- Acute Disease -
- Aged -
- Angina, Unstable - complications
- Female - complications
- Heart Failure, Congestive - diagnosis
- Hospital Mortality - diagnosis
- Humans - diagnosis
- Male - diagnosis
- Middle Aged - diagnosis
- Myocardial Infarction - complications
- Prognosis - complications
- Prospective Studies - complications
- Registries - complications
- Syndrome - complications
- Time Factors - complications
- Find related publications in this database (Keywords)
- heart failure
- prognosis
- myocardial infarction
- angina