Coronary angiography in patients with acute heart failure: from the KCHF registry.
Coronary angiography in patients with acute heart failure: from the KCHF registry.
复制标题
DOI：
10.1002/ehf2.13716
复制
发表时间：
2022-03
影响因子：
3.8
通讯作者：
KCHF Study Investigators
中科院分区：
文献类型：
--
作者：
Seko Y;Kishimori T;Kato T;Morimoto T;Yaku H;Inuzuka Y;Tamaki Y;Ozasa N;Shiba M;Yamamoto E;Yoshikawa Y;Yamashita Y;Kitai T;Taniguchi R;Iguchi M;Nagao K;Kawai T;Komasa A;Nishikawa R;Kawase Y;Morinaga T;Toyofuku M;Furukawa Y;Ando K;Kadota K;Sato Y;Kuwahara K;Kimura T;KCHF Study Investigators
对于在心力衰竭（HF）住院期间接受冠状动脉造影术的患者、冠状动脉狭窄患者以及接受冠状动脉血运重建的患者的特征和结局知之甚少。我们分析了2163例因HF住院的患者，这些患者没有急性冠脉综合征或既往HF住院史。我们根据（i）有与无冠状动脉造影的患者，（ii）有与无冠状动脉狭窄的患者，（iii）有与无冠状动脉血运重建的患者，比较患者特征和1年临床结局。主要结局指标为全因死亡或HF住院的复合终点。37.0%的患者进行了冠状动脉造影。多因素Logistic回归分析显示，与冠状动脉造影独立相关的因素为年龄< 80岁[校正比值比（OR）= 1.76，95%可信区间（CI）= 1.41-2.20，P < 0.001]，男性（调整OR = 1.28，95% CI = 1.03-1.59，P = 0.02），糖尿病（调整OR = 1.27，95% CI = 1.02-1.60，P = 0.04），无房颤或房扑（调整后OR = 1.45，95% CI = 1.17-1.82，P < 0.001），既往未植入器械（校正OR = 1.81，95% CI = 1.13-2.91，P = 0.01），目前吸烟（校正OR = 1.40，95%CI = 1.05-1.87，P = 0.02），无认知功能障碍（校正OR = 1.90，95%CI = 1.34-2.69，P < 0.001），门诊状态（校正OR = 2.89，95%CI = 2.03-4.10，P < 0.001），HF伴射血分数降低（校正OR = 1.55，95%CI = 1.24-1.93，P < 0.001），估计肾小球滤过率≥ 30 mL/min/1.73 m2（校正OR = 1.93，95%CI = 1.45-2.58，P < 0.001），无贫血（校正OR = 1.27，95% CI = 1.02-1.59，P = 0.04），入院前未开具β受体阻滞剂处方（校正OR = 1.32，95%CI = 1.03-1.68，P = 0.03）。行冠状动脉造影的患者发生主要结局的风险较低[校正风险比（HR）= 0.70，95% CI = 0.58-0.85，P < 0.001]。在接受冠状动脉造影的患者中，有冠状动脉狭窄的患者（38.9%）的主要结局指标风险并不低于无冠状动脉狭窄的患者（校正HR = 0.93，95%CI = 0.65-1.32，P = 0.68）。在冠状动脉狭窄患者中，行冠状动脉血运重建的患者（54.3%）的主要结局指标风险并不高于未行冠状动脉血运重建的患者（校正HR = 1.36，95% CI = 0.84-2.21，P = 0.22）。在急性HF患者中，接受冠状动脉造影术的患者临床结局风险较低，与未接受冠状动脉造影术的患者有显著差异。
Little is known about the characteristics and outcomes of patients who undergo coronary angiography during heart failure (HF) hospitalization, as well as those with coronary stenosis, and those who underwent coronary revascularization. We analysed 2163 patients who were hospitalized for HF without acute coronary syndrome or prior HF hospitalization. We compared patient characteristics and 1 year clinical outcomes according to (i) patients with versus without coronary angiography, (ii) patients with versus without coronary stenosis, and (iii) patients with versus without coronary revascularization. The primary outcome measure was the composite of all‐cause death or HF hospitalization. Coronary angiography was performed in 37.0% of patients. In the multivariable logistic regression analysis, factors independently associated with coronary angiography were age < 80 years [adjusted odds ratio (OR) = 1.76, 95% confidence interval (CI) = 1.41–2.20, P < 0.001], men (adjusted OR = 1.28, 95% CI = 1.03–1.59, P = 0.02), diabetes (adjusted OR = 1.27, 95% CI = 1.02–1.60, P = 0.04), no atrial fibrillation or flutter (adjusted OR = 1.45, 95% CI = 1.17–1.82, P < 0.001), no prior device implantation (adjusted OR = 1.81, 95% CI = 1.13–2.91, P = 0.01), current smoking (adjusted OR = 1.40, 95% CI = 1.05–1.87, P = 0.02), no cognitive dysfunction (adjusted OR = 1.90, 95% CI = 1.34–2.69, P < 0.001), ambulatory status (adjusted OR = 2.89, 95% CI = 2.03–4.10, P < 0.001), HF with reduced ejection fraction (adjusted OR = 1.55, 95% CI = 1.24–1.93, P < 0.001), estimated glomerular filtration rate ≥ 30 mL/min/1.73 m2 (adjusted OR = 1.93, 95% CI = 1.45–2.58, P < 0.001), no anaemia (adjusted OR = 1.27, 95% CI = 1.02–1.59, P = 0.04), and no prescription of β‐blockers prior to admission (adjusted OR = 1.32, 95% CI = 1.03–1.68, P = 0.03). Patients who underwent coronary angiography had a lower risk of the primary outcome [adjusted hazard ratio (HR) = 0.70, 95% CI = 0.58–0.85, P < 0.001]. Among the patients who underwent coronary angiography, those with coronary stenosis (38.9%) did not have lower risk of the primary outcome measure than those without coronary stenosis (adjusted HR = 0.93, 95% CI = 0.65–1.32, P = 0.68). Among the patients with coronary stenosis, those with coronary revascularization (54.3%) did not have higher risk of the primary outcome measure than those without coronary revascularization (adjusted HR = 1.36, 95% CI = 0.84–2.21, P = 0.22). In patients with acute HF, patients who underwent coronary angiography had a lower risk of clinical outcomes and were significantly different from those who did not undergo coronary angiography.
登录
查看更多内容
对医疗统计信息的自由使用的易于使用的软件“ EZR”的调查。
影响因子：
4.8
作者：
Kanda Y
通讯作者：
Kanda Y
影响因子：
3.8
作者：
Yamamoto E;Kato T;Ozasa N;Yaku H;Inuzuka Y;Tamaki Y;Kitai T;Morimoto T;Taniguchi R;Iguchi M;Kato M;Takahashi M;Jinnai T;Ikeda T;Nagao K;Kawai T;Komasa A;Nishikawa R;Kawase Y;Morinaga T;Kawashima T;Motohashi Y;Kawato M;Toyofuku M;Sato Y;Kuwahara K;Shioi T;Kimura T;KCHF study investigators
通讯作者：
KCHF study investigators
影响因子：
2.3
作者：
Levine, Glenn N.;Bates, Eric R.;Zhao, David X.
通讯作者：
Zhao, David X.
影响因子：
4.8
作者：
Flaherty, James D.;Rossi, Joseph S.;Gheorghiade, Mihai
通讯作者：
Gheorghiade, Mihai
影响因子：
1.8
作者：
Schroeder, M A
通讯作者：
Schroeder, M A