Document Detail


Predictors of heart failure in patients with stable coronary artery disease: a PEACE study.
MedLine Citation:
PMID:  19808342     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Heart failure (HF) is a disease commonly associated with coronary artery disease. Most risk models for HF development have focused on patients with acute myocardial infarction. The Prevention of Events with Angiotensin-Converting Enzyme Inhibition population enabled the development of a risk model to predict HF in patients with stable coronary artery disease and preserved ejection fraction.
METHODS AND RESULTS: In the 8290, Prevention of Events with Angiotensin-Converting Enzyme Inhibition patients without preexisting HF, new-onset HF hospitalizations, and fatal HF were assessed over a median follow-up of 4.8 years. Covariates were evaluated and maintained in the Cox regression multivariable model using backward selection if P<0.05. A risk score was developed and converted to an integer-based scoring system. Among the Prevention of Events with Angiotensin-Converting Enzyme Inhibition population (age, 64+/-8; female, 18%; prior myocardial infarction, 55%), there were 268 cases of fatal and nonfatal HF. Twelve characteristics were associated with increased risk of HF along with several baseline medications, including older age, history of hypertension, and diabetes. Randomization to trandolapril independently reduced the risk of HF. There was no interaction between trandolapril treatment and other risk factors for HF. The risk score (range, 0 to 21) demonstrated excellent discriminatory power (c-statistic 0.80). Risk of HF ranged from 1.75% in patients with a risk score of 0% to 33% in patients with risk score >or=16.
CONCLUSIONS: Among patients with stable coronary artery disease and preserved ejection fraction, traditional and newer factors were independently associated with increased risk of HF. Trandolopril decreased the risk of HF in these patients with preserved ejection fraction.
Authors:
Eldrin F Lewis; Scott D Solomon; Kathleen A Jablonski; Madeline Murguia Rice; Francesco Clemenza; Judith Hsia; Aldo P Maggioni; Miguel Zabalgoitia; Thao Huynh; Thomas E Cuddy; Bernard J Gersh; Jean Rouleau; Eugene Braunwald; Marc A Pfeffer;
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-04-14
Journal Detail:
Title:  Circulation. Heart failure     Volume:  2     ISSN:  1941-3297     ISO Abbreviation:  Circ Heart Fail     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-10-07     Completed Date:  2009-10-27     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  101479941     Medline TA:  Circ Heart Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  209-16     Citation Subset:  IM    
Affiliation:
Cardiovascular Division, Brigham and Women's Hospital, Boston, Mass 02115, USA. eflewis@partners.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Coronary Artery Disease / complications*,  drug therapy,  mortality,  physiopathology
Female
Heart Failure / etiology*,  mortality,  physiopathology,  prevention & control
Humans
Indoles / therapeutic use*
Kaplan-Meier Estimate
Male
Middle Aged
Predictive Value of Tests
Proportional Hazards Models
Risk Assessment
Risk Factors
Stroke Volume / drug effects
Time Factors
Treatment Outcome
Ventricular Function, Left / drug effects
Grant Support
ID/Acronym/Agency:
N01 HC065149-00/HC/NHLBI NIH HHS; N01 HC65149/HC/NHLBI NIH HHS; N01HC065149/HC/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Indoles; 87679-37-6/trandolapril
Comments/Corrections

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