Effect of acute heart failure following discharge in patients with non-st-elevation acute coronary syndrome on the subsequent risk of death or acute myocardial infarction

  • Nunez J
  • Sanchis J
  • Nunez E
 et al. 
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Abstract

Introduction and objectives: Little is known about how prognosis is influenced by readmission for acute heart failure (AHF) following non-ST-segment elevation acute coronary syndrome (NSTEACS). The aim of this study was to determine the prognostic effect of a first admission for AHF on the risk of acute myocardial infarction (AMI) or death in patients who survived an episode of high-risk NSTEACS. Methods: The study involved 972 consecutive patients with high-risk NSTEACS who survived after hospital admission. Readmission for AHF was selected as the main exposure variable, and its association with subsequent AMI or all-cause death was assessed using Cox proportional hazards models for time-dependent covariates that also included adjustment for competing risks. Results: After a median follow-up period of 30 [interquartile range, 12-48] months, 82 patients (8.4%) were admitted for AHF, 146 (15%) had an AMI, and 202 (20.8%) died. The median time to readmission for AHF was 203 [56-336] days after NSTEACS. Patients readmitted for AHF had an increased risk of subsequent death (hazard ratio [HR]=1.67; 95% confidence interval [CI], 1.13-2.45; P=.009) or AMI (HR=2.15; 95% CI, 1.41-3.27; P

Author-supplied keywords

  • acute coronary syndrome
  • acute heart failure
  • acute heart infarction
  • aged
  • article
  • female
  • follow up
  • hospital admission
  • hospital discharge
  • hospital readmission
  • human
  • major clinical study
  • male
  • non st segment elevation acute coronary syndrome
  • prognosis

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Authors

  • J Nunez

  • J Sanchis

  • E Nunez

  • V Bodi

  • L Mainar

  • G Minana

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