Prevalence and characteristics of coronary artery disease in heart failure with preserved and mid-range ejection fractions: A systematic angiography approach

Autor: Lory Trevisan, Jennifer Cautela, Johan Pinto, Morgane Orabona, Michael Peyrol, Stephane Arques, Franck Paganelli, Franck Thuny, Jeremie Barraud, Noémie Resseguier, Laurent Bonello, Marc Laine
Přispěvatelé: Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU)
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Archives of cardiovascular diseases
Archives of cardiovascular diseases, Elsevier/French Society of Cardiology, 2018, 111 (2), pp.109-118. ⟨10.1016/j.acvd.2017.05.006⟩
ISSN: 1875-2136
1875-2128
DOI: 10.1016/j.acvd.2017.05.006⟩
Popis: Summary Background Guidelines recommend careful screening and treatment of coronary artery disease (CAD) in heart failure with preserved or mid-range ejection fraction (HFpEF/HFmEF). Aim We aimed to determine the prevalence and characteristics of CAD using a prospective systematic coronary angiography approach. Methods A systematic coronary angiography protocol was applied in consecutive patients admitted for HFpEF/HFmEF during a 6-month period in a single centre. History of CAD and results of angiography, including revascularization, were reported. Results Of the 164 patients with HFpEF/HFmEF who were included, an angiography assessment was applied in 108 (66%) (median age: 79 years [interquartile range: 70–85 years]; 54% were women). In our analysis, 64% (95% confidence interval [CI] 55–73%) of patients had a significant coronary stenosis corresponding to a global CAD prevalence of 80% (95% CI 73–88%). The prevalence of CAD was similar for HFpEF and HFmEF. The left main coronary artery presented a significant stenosis in 6.5% of cases and 39% of patients had a two- or three-vessel disease. The rate of significant coronary stenosis was non-significantly higher in patients with a history of CAD. Patients with HFpEF/HFmEF with and without CAD did not differ in clinically meaningful ways, in terms of symptoms or laboratory and echocardiography results. This strategy led to complete revascularization in 36% of patients with significant stenosis and in 23% of all patients with HFpEF/HFmEF. Conclusions Our study differs from others in that we used a systematic angiography approach. The results suggest a much higher prevalence of CAD in HFpEF/HFmEF than previously reported and should encourage clinicians to aggressively identify this co-morbidity.
Databáze: OpenAIRE
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