Document Detail


Utilization and outcome of coronary revascularization and valve procedures in acute heart failure--an evaluation based on the classification from the European Society of Cardiology.
MedLine Citation:
PMID:  18603542     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early invasive treatments in patients with acute heart failure (AHF) are critical components to improve outcome. We aimed to establish if such treatments were applied according to existing guidelines and also to assess the subsequent mortality in the complete AHF population. All patients with AHF admitted to the intensive care unit/coronary care unit during the years 2003-2004 (n=302) were retrospectively reviewed and classified according to the European Society of Cardiology. Invasive revascularization was applied more frequently in patients with cardiogenic shock following acute coronary syndromes (78%, n=40) than in less severe AHF (58%, n=62, P<0.05). Only 8% (n=4) of eligible patients with acute coronary syndromes and cardiogenic shock were treated non-invasively. Valvular dysfunction was a precipitating factor for AHF in 15% (n=38). Acute mitral regurgitation was treated surgically exclusively in patients with mechanical defects. In-hospital mortality rates for less severe AHF was 12%, cardiogenic shock 46% and postcardiotomy HF 32%. Invasively treated patients had lower in-hospital mortality in both cardiogenic shock (35% vs. 70%, P=0.006) and less severe AHF (6% vs.17%, P=0.042). The study revealed an appropriate use of invasive revascularization. The high mortality in patients with severe AHF indicates that more effective treatment options are needed in eligible patients.
Authors:
Stig Eggen Hermansen; Magna Hansen; Marius Roaldsen; Stig Muller; Ole-Jakob How; Truls Myrmel;
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-07-04
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  7     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-19     Completed Date:  2008-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  833-8     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, 9038 Tromsø, Norway. Stig.Eggen.Hermansen@unn.no
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / complications,  mortality,  therapy*
Acute Disease
Adult
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / utilization*
Coronary Artery Bypass / utilization*
Europe
Female
Guideline Adherence
Heart Failure / etiology,  mortality,  therapy*
Heart Valve Diseases / complications,  mortality,  surgery*
Heart Valve Prosthesis Implantation / utilization*
Hospital Mortality
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Practice Guidelines as Topic
Retrospective Studies
Severity of Illness Index
Shock, Cardiogenic / etiology,  mortality,  therapy*
Societies, Medical
Time Factors
Treatment Outcome

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