Revascularization for Patients With Heart Failure With Preserved Ejection Fraction and Coronary Artery Disease

• Published in: The American journal of cardiology 2024-02, Vol.213, p.86-92
• Main Authors: Fu, Mingqiang, Wang, Yanyan, Han, Xueting, Yuan, Shuai, Liu, Yuan, Qian, Juying, Zhou, Jingmin, Ge, Junbo
• Format: Article
• Language: English
• Subjects: Angiography; Bleeding; Blood vessels; Cardiac arrhythmia; Cardiovascular disease; Cerebral infarction; Congestive heart failure; Coronary artery disease; Coronary vessels; Death; Diabetes; Ejection fraction; Enzymes; Heart attacks; Heart diseases; Heart failure; Hemoglobin; Hemorrhage; Hyperlipidemia; Hypertension; Implants; Kidney diseases; Medical imaging; Medical prognosis; Morbidity; Mortality; Myocardial infarction; Pathophysiology; Regression analysis; Restenosis; Risk factors; Stroke; Surgery; Vein & artery diseases; Ventricle
• ISSN: 0002-9149; 1879-1913; 1879-1913
• DOI: 10.1016/j.amjcard.2023.07.175

Coronary artery disease (CAD) is one of the main causes of heart failure (HF) with preserved ejection fraction (HFpEF). The efficacy of revascularization therapy in patients with HFpEF and CAD, however, remains unclear. Patients who underwent coronary angiography from January 2017 to December 2019 were included in this retrospective study if they further satisfied the diagnosis of HFpEF (left ventricular ejection fraction ≥50% plus plasma N-terminal pro-BNP ≥125 pg/ml) and CAD (patients had a history of confirmed myocardial infarction or ≥50% stenosis in at least 1 epicardial coronary vessel). Clinical data, way of revascularization, and outcome events (unplanned repeated revascularization, HF readmission, cardiovascular death, readmission of cerebral hemorrhage/stroke or gastrointestinal bleeding, and all-cause death) were recorded and analyzed. A total of 1,111 patients were enrolled for the present analysis. Based on whether the revascularization was complete or not, the patients were divided into the complete revascularization group (n = 780) and the incomplete/no revascularization group (n = 331). All patients were followed up with a median of 355 days. The overall rates of unplanned repeated revascularization, HF readmission, and cardiovascular death were 6.6%, 5.0%, and 0.4%, respectively. Compared with incompletely/not revascularized patients, completely revascularized patients had a lower rate of unplanned repeated revascularization (10.9% vs 4.7%, p