January 1, 2005Canadian Journal of Physiology and Pharmacology
Congestive heart failure complicating non-ST segment elevation acute coronary syndrome: incidence, predictors, and clinical outcomes
Key result
Developing CHF after NSTE-ACS is linked to ~240% higher mortality and increased MI risk.
- OR 3.4
- 95% CI 2.7-4.3
- n=10,141
Why the study?
There are limited data regarding the incidence and clinical significance of congestive heart failure in patients with non-ST segment elevation acute coronary syndromes.
Does the development of congestive heart failure worsen clinical outcomes in patients with non-ST segment elevation acute coronary syndromes?
Population
10,141 patients with unstable angina or NSTEMI in the OASIS-2 trial
Comparison
Patients developing CHF vs patients not developing CHF
Design
Cohort study of patients randomized to hirudin or unfractionated heparin
Follow-up
6 months
Authors
Discussion
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Member takes
Implication
CHF after NSTE-ACS marks substantially worse prognosis; leaves open whether targeted interventions improve outcomes in this high-risk group.
Study Design
Type
Cohort (n=10,141)
Multicenter
Yes
Structured PICO
Does the development of congestive heart failure worsen clinical outcomes in patients with non-ST segment elevation acute coronary syndromes?
P
Population
10,141 patients with unstable angina or NSTEMI from the OASIS-2 trial, followed for 6 months to assess the incidence and outcomes of developing congestive heart failure.
E
Exposure
Development of congestive heart failure (CHF)
C
Comparator
No development of congestive heart failure (CHF)
O
Outcome
Incidence of CHF, predictors of CHF, and clinical outcomes (death, new MI, need for intra-aortic balloon pump insertion, cardiac catheterization, revascularization) at 7 days and 6 monthshard clinical
Main Result
Odds Ratio: 3.4 (95% CI 2.7–4.3)
The development of congestive heart failure in patients with non-ST segment elevation ACS is common and strongly associated with increased mortality and recurrent MI, yet these patients are less likely to receive invasive management.
Cite This Study
Mehta et al. (2005) conducted a cohort in non-ST segment elevation acute coronary syndromes (ACS) (n=10,141). Congestive heart failure (CHF) vs. No congestive heart failure was evaluated on Death (OR 3.4, 95% CI 2.7-4.3). Developing congestive heart failure after non-ST segment elevation ACS was associated with increased risk of death (OR 3.4; 95% CI 2.7-4.3) and new MI (OR 2.8; 95% CI 2.2-3.6).