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Acute heart failure with and without concomitant acute coronary syndromes - patient characteristics, management and survival.
MedLine Citation:
PMID:  25079300     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Acute coronary syndromes (ACS) may precipitate up to a third of acute heart failure (AHF) cases. We assessed the characteristics, initial management, and survival of AHF patients with (ACS-AHF) and with no concomitant ACS (nACS-AHF).
METHODS AND RESULTS: Data from 620 AHF patients were analyzed in a prospective multicenter study. The ACS-AHF patients (32%) more often presented with de novo AHF (61% vs. 43% in nACS-AHF, p<0.001). Although no differences existed between the two groups in mean blood pressure, heart rate, or routine biochemistry on admission, cardiogenic shock and pulmonary edema were more common manifestations in ACS-AHF (p<0.01 for both). Use of intravenous nitrates, furosemide, opioids, inotropes, and vasopressors as well as non-invasive ventilation and invasive coronary procedures (angiography, percutaneous coronary intervention, coronary artery bypass graft surgery) were more frequent in ACS-AHF (p<0.001 for all). Although 30-day mortality was significantly higher for ACS-AHF (13 vs. 8%, p=0.03), survival in the two groups at 5 years was similar. Overall, ACS was an independent predictor of 30-day mortality (adjusted OR 2.0, 95% CI 1.07-3.79, p=0.03).
CONCLUSION: Whereas medical history and the manifestation and initial treatment of AHF between ACS-AHF and nACS-AHF patients differ, long-term survival is similar. ACS is, however, independently associated with increased short-term mortality.
Authors:
Tuukka Tarvasmäki; Veli-Pekka Harjola; Markku S Nieminen; Krista Siirilä-Waris; Jukka Tolonen; Heli Tolppanen; Johan Lassus;
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-28
Journal Detail:
Title:  Journal of cardiac failure     Volume:  -     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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