Background. There is a lack of recent data on incidence, correlates, and prognosis associated with the development of heart failure (HF) in patients with stable coronary artery disease (CAD). Objectives: To analyze the risk of hospitalization for HF, together with relevant associated factors, and related mortality, in stable CAD outpatients. Methods: The multicenter CORONOR registry enrolled 4184 unselected outpatients with stable CAD (ie myocardial infarction (MI) and/or coronary revascularization >1 year previously). Five‐year clinical follow‐up was achieved for 3785 (98%) of the 3781 patients who had no history of hospitalization for HF at inclusion. Results: Hospitalization for HF occurred in 6.1% of the patients at 5‐year and was a powerful predictor of mortality in a time‐dependent analysis (age and sex adjusted HR=7.62 [6.0‐9.68]; P<0.0001). Six variables were independently associated with hospitalization for HF: left ventricular ejection fraction (LVEF), age, diabetes mellitus, atrial fibrillation, history of hypertension, and low estimated glomerular filtration rate. As most patients had a normal LVEF at inclusion (mean=59+/‐10%; 86% with LVEF >= 50%), although low LVEF was a strong predictor of hospitalization for HF, a majority of them (62%) occurred in patients with preserved LVEF. Interim MI was strongly associated with hospitalization for HF (HR=3.63 [2.17‐6.08]; P<0.0001) but was a relatively rare circumstance (7.6% of the patients hospitalized for HF). Conclusions: HF development remained relatively frequent in patients with stable CAD and was associated with a high risk of mortality. Although the LVEF at inclusion was a strong predictor of HF, we emphasized that the majority of cases of HF occurred in patients with preserved LVEF at inclusion and without an interim MI. (Figure presented).
Lamblin, N., Meurice, T., Tricot, O., De Groote, P., Lemesle, G., & Bauters, C. (2017). Hospitalization for heart failure in stable coronary artery disease outpatients: determinants, role of interim myocardial infarction, and prognosis. Archives of Cardiovascular Diseases Supplements, 9(2), 207. https://doi.org/10.1016/s1878-6480(17)30512-8