Impact of hospitalization for acute coronary events on subsequent mortality in patients with chronic heart failure

被引：22

作者：

Abrahamsson, Putte ^{[1
]}

Dobson, Joanna ^{[2
]}

Granger, Christopher B. ^{[3
]}

McMurray, John J. V. ^{[4
]}

Michelson, Eric L. ^{[5
]}

Pfeffer, Marc ^{[6
,7
]}

Pocock, Stuart ^{[2
]}

Solomon, Scott D. ^{[6
,7
]}

Yusuf, Salim ^{[8
]}

Swedberg, Karl ^{[1
]}

机构：

[1] Univ Gothenburg, Sahlgrenska Acad, Dept Emergency & Cardiovasc Med, Gothenburg, Sweden

[2] London Sch Hyg & Trop Med, Med Stat Unit, London WC1, England

[3] Duke Univ, Med Ctr, Dept Cardiol, Durham, NC USA

[4] Univ Glasgow, British Heart Fdn Cardiovasc Res Ctr, Glasgow, Lanark, Scotland

[5] AstraZeneca LP, Wilmington, DE USA

[6] Brigham & Womens Hosp, Dept Cardiol, Boston, MA 02115 USA

[7] Harvard Univ, Boston, MA 02115 USA

[8] HGM McMaster Clin, Dept Med, Hamilton, ON, Canada

来源：

EUROPEAN HEART JOURNAL | 2009年 / 30卷 / 03期

关键词：

Chronic heart failure; Acute myocardial infarction; Unstable angina pectoris; Prognosis; LEFT-VENTRICULAR DYSFUNCTION; MYOCARDIAL-INFARCTION; POPULATION; MORBIDITY; TRENDS;

D O I：

10.1093/eurheartj/ehn503

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We explored the impact of having a hospital admission for an acute coronary syndrome (ACS) on the subsequent prognosis among patients with chronic heart failure (CHF). A total of 7599 patients with CHF, New York Heart Association Classes II-IV, were randomly assigned to candesartan or placebo. We assessed the risk of death after a first ACS using time-updated Cox proportional hazard models adjusted for baseline predictors. During a mean follow-up of 3.3 years, 1174 patients experienced at least one ACS. Myocardial infarction (MI) was the first ACS in 442 subjects and unstable angina (UA) in 732. After these events, 219 (49.5%) and 167 (22.8%) patients died during follow-up. The early risk of death was more pronounced after MI: 30.2% died within 30 days compared with 3.6% after UA. After an ACS event, the risk of death declined steadily over time, although 18 months after an MI the risk was still twice that of patients without an ACS. Patients with CHF, who develop an ACS, have markedly increased subsequent mortality, particularly in the early phase after an MI.

引用

页码：338 / 345

页数：8

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