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Treatment response ...
Treatment response in recent-onset heart failure with reduced ejection fraction: non-ischaemic vs. ischaemic aetiology.
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- Silverdal, Jonas (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Bollano, Entela, 1970 (author)
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Henrysson, Josefin (author)
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- Basic, Carmen, 1975 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Fu, Michael, 1963 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Sjöland, Helen, 1959 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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(creator_code:org_t)
- 2022-11-04
- 2023
- English.
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In: ESC heart failure. - : Wiley. - 2055-5822. ; 10:1, s. 542-551
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Abstract
Subject headings
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- In heart failure (HF) with reduced left ventricular ejection fraction (HFrEF), the prognosis appears better in non-ischaemic than in ischaemic aetiology. Infrequent diagnostic work-up for ischaemic heart disease (IHD) in HF is reported. In this study, we compared short-term response to initiated guideline-directed medical treatment (GDMT) in recent-onset HFrEF of non-ischaemic (non-IHF) vs. ischaemic (IHF) aetiology and evaluated the frequency of coronary investigation.Patients hospitalized with recent-onset HFrEF [left ventricular ejection fraction (LVEF)<40%] between 1 January 2016 and 31 December 2019 were included. Treatment response was determined by use of a hierarchical clinical composite outcome classifying each patient as worsened, improved, or unchanged based on hard outcomes (mortality, heart transplantation, and HF hospitalization) and soft outcomes (±≥10 unit change in LVEF, ±≥30% change in N-terminal pro-B-type natriuretic peptide, and ±≥1 point change in New York Heart Association functional class) during 28weeks of follow-up. The associations between baseline characteristics and composite changes were analysed with multiple logistic regression. Among the 364 patients analysed, 47 were not investigated for IHD. Comparing non-IHF (n=203) vs. IHF (n=114), patients were younger (mean age 61.0 vs. 69.4years, P<0.001) with lower mean LVEF (26% vs. 31%, P<0.001), but with similar male predominance (70.4% vs. 75.4%, P=0.363). For non-IHF vs. IHF, the composite outcomes were worsened (19.1% vs. 43.9%, P<0.001) and improved (74.2% vs. 43.9%, P<0.001). After multivariable adjustments, IHF was associated with increased odds for worsening [odds ratio (OR) 2.94; 95% confidence interval (CI) 1.51-5.74; P=0.002] and decreased odds for improvement (OR 0.35; 95% CI 0.18-0.65; P<0.001). In cases without previous IHD or new-onset myocardial infarction (n=261), a decision for coronary investigation was made in 69.0%.In recent-onset HFrEF, patients with non-IHF responded better to GDMT than patients with IHF. Almost one-third of patients selected for follow-up at HF clinics were never investigated for IHD.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Coronary investigation
- Heart failure
- Ischaemic heart disease
- Non-ischaemic heart failure
- Recent-onset heart failure
- Treatment response
- systolic
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Silverdal, Jonas
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Bollano, Entela, ...
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Henrysson, Josef ...
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Basic, Carmen, 1 ...
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Fu, Michael, 196 ...
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Sjöland, Helen, ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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ESC heart failur ...
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University of Gothenburg