IncidenCe and predictOrs of heaRt fAiLure after acute coronarY Syndrome: The CORALYS registry

• Published in: International journal of cardiology 2023-01, Vol.370, p.35-42
• Main Authors: De Filippo, Ovidio, D'Ascenzo, Fabrizio, Wańha, Wojciech, Leonardi, Sergio, Raposeiras Roubin, Sergio, Fabris, Enrico, Truffa Giachet, Alessandra, Huczek, Zenon, Gaibazzi, Nicola, Ielasi, Alfonso, Cortese, Bernardo, Borin, Andrea, Núñez-Gil, Iván J., Ugo, Fabrizio, Marengo, Giorgio, Bianco, Matteo, Barbieri, Lucia, Marchini, Federico, Desperak, Piotr, Melendo-Viu, María, Montalto, Claudio, Bruno, Francesco, Mancone, Massimo, Ferrandez-Escarabajal, Marcos, Morici, Nuccia, Scaglione, Marco, Tuttolomondo, Domenico, Gąsior, Mariusz, Mazurek, Maciej, Gallone, Gugliemo, Campo, Gianluca, Wojakowski, Wojciech, Abu Assi, Emad, Sinagra, Gianfranco, de Ferrari, Gaetano Maria
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Acute Coronary Syndrome - complications; Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - epidemiology; Heart failure; Heart Failure - diagnosis; Heart Failure - epidemiology; Heart Failure - etiology; Hospitalization; Humans; Percutaneous coronary intervention; Percutaneous Coronary Intervention - adverse effects; Retrospective Studies; Stroke Volume; Ventricular Function, Left
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2022.10.146

Previous studies investigating predictors of Heart Failure (HF) after acute coronary syndrome (ACS) were mostly conducted during fibrinolytic era or restricted to baseline characteristics and diagnoses prior to admission. We assessed the incidence and predictors of HF hospitalizations among patients treated with percutaneous coronary intervention (PCI) for ACS. CORALYS is a multicenter, retrospective, observational registry including consecutive patients treated with PCI for ACS. Patients with known history of HF or reduced left ventricular ejection fraction (LVEF) were excluded. Incidence of HF hospitalizations was the primary endpoint. The composite of HF hospitalization or cardiovascular death, and cardiovascular and all-cause death were the secondary endpoints. Predictors of HF hospitalizations and the impact of HF hospitalization on cardiovascular and all-cause death were assessed by means of multivariable Cox proportional hazards model.14699 patients were included. After 2.9 ± 1.8 years, the incidence of HF hospitalizations was 12.7%. Multivariable analysis identified age, diabetes, chronic kidney disease, previous myocardial infarction, atrial fibrillation, pulmonary disease, GRACE risk-score ≥ 141, peripheral artery disease, cardiogenic shock at admission and LVEF ≤40% as independently associated with HF hospitalizations. Complete revascularization was associated with a lower risk of HF (HR 0.46,95%CI 0.39–0.55). HF hospitalization was associated with higher risk of CV and all-cause death (HR 1.89,95%CI 1.5–2.39 and HR 1.85,95%CI 1.6–2.14, respectively). Incidence of HF hospitalizations among patients treated with PCI for ACS is not negligible and is associated with detrimental impact on patients' prognosis. Several variables may help to assess the risk of HF after ACS. Central Illustration: Summary of study findings. HF: heart failure; CV: cardiovascular; PCI: percutaneous coronary intervention; PAD: peripheral artery disease; MI: myocardial infarction; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; LVEF: left ventricular ejection fraction; CS: cardiogenic shock. [Display omitted] •Incidence of heart failure after ACS in the modern PCI era is still not negligible•Several clinical and procedural variables may help identifying patients at high risk of developing HF after ACS.•We report that HF development is associated with an impaired prognosis among patients treated with PCI for ACS.•Identification of patients at high ri