Impact of hospitalization for acute coronary events on subsequent mortality in patients with chronic heart failure

Abrahamsson, Putte,1965Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine (author)

AIMS: We explored the impact of having a hospital admission for an acute coronary syndrome (ACS) on the subsequent prognosis among patients with chronic heart failure (CHF). METHODS AND RESULTS: A total of 7599 patients with CHF, New York Heart Association Classes II-IV, were randomly assigned to candesartan or placebo. We assessed the risk of death after a first ACS using time-updated Cox proportional hazard models adjusted for baseline predictors. During a mean follow-up of 3.3 years, 1174 patients experienced at least one ACS. Myocardial infarction (MI) was the first ACS in 442 subjects and unstable angina (UA) in 732. After these events, 219 (49.5%) and 167 (22.8%) patients died during follow-up. The early risk of death was more pronounced after MI: 30.2% died within 30 days compared with 3.6% after UA. After an ACS event, the risk of death declined steadily over time, although 18 months after an MI the risk was still twice that of patients without an ACS. CONCLUSION: Patients with CHF, who develop an ACS, have markedly increased subsequent mortality, particularly in the early phase after an MI.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Acute Coronary Syndrome/complications/*mortality
Age Distribution
Aged
Aged
80 and over
Angina
Unstable/complications/mortality
Angiotensin II Type 1 Receptor Blockers/therapeutic use
Benzimidazoles/therapeutic use
Chronic Disease
Double-Blind Method
Female
Heart Failure/complications/drug therapy/*mortality
Hospitalization
Humans
Male
Middle Aged
Myocardial Infarction/complications/mortality
Prognosis
Tetrazoles/therapeutic use

Dobson, J. (author)
Granger, C. B. (author)
McMurray, J. J. (author)
Michelson, E. L. (author)
Pfeffer, M. (author)
Pocock, S. (author)
Solomon, S. D. (author)
Yusuf, S. (author)
Swedberg, Karl,1944Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine(Swepub:gu)xsweka (author)
Göteborgs universitetInstitutionen för medicin, avdelningen för akut och kardiovaskulär medicin (creator_code:org_t)

By the author/editor: Abrahamsson, Put ...; Dobson, J.; Granger, C. B.; McMurray, J. J.; Michelson, E. L.; Pfeffer, M.; show more...; Pocock, S.; Solomon, S. D.; Yusuf, S.; Swedberg, Karl, ...; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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