Background
Methods
Patient cohort
Data collection
Echocardiography
Categorization of heart failure
Cardiovascular risk factors and comorbidities
Implementation of guideline recommendations on pharmacotherapy
Adherence to non-pharmacological advice
Data analysis
Results
Stage of Heart Failure | ||||
---|---|---|---|---|
A | B | C | p | |
N (%) | 20 (3.9) | 264 (51.9) | 225 (44.2) | |
Age (years), mean (SD) | 56.3 (8.3) | 66.8 (8.2) | 68.1 (9.1) | <0.0011
|
Male sex, n (%) | 16 (80.0) | 221 (83.7) | 180 (80.0) | 0.5142
|
Time since index event (months), mean (SD) | 20.4 (8.6) | 20.8 (9.1) | 22.2 (8.7) | 0.1941
|
Index event | ||||
Acute, n (%) | 20 (100) | 259 (98.5) | 223 (99.6) | 0.9492
|
Primary CHD event, n (%) | 4 (20.0) | 71 (26.9) | 54 (24.0) | 0.6962
|
Affected vessels | ||||
Main left coronary artery, n (%) | 0 | 15 (6.8) | 18 (9.5) | 0.3642
|
LAD, n (%) | 11 (64.7) | 145 (65.9) | 140 (74.1) | 0.1712
|
RCX, n (%) | 9 (52.9) | 106 (48.2) | 93 (49.2) | 0.9122
|
RCA, n (%) | 7 (41.2) | 117 (53.2) | 96 (50.8) | 0.622
|
Number of affected vessels | 0.6992
| |||
1, n (%) | 9 (52.9) | 100 (45.5) | 85 (45.0) | |
2, n (%) | 6 (35.3) | 68 (30.9) | 62 (32.8) | |
3, n (%) | 2 (11.8) | 44 (20.0) | 40 (21.2) | |
Duration of CHD (years), median (IQR) | 2.0 (1.4–3.4) | 2.8 (1.9–10.1) | 2.9 (2.0–9.9) | 0.0273
|
Treatment for index event | 0.4172
| |||
Conservative, n (%) | 6 (30.0) | 38 (14.4) | 37 (16.4) | |
CABG, n (%) | 2 (10.0) | 45 (17.0) | 32 (14.2) | |
PCI, n (%) | 12 (60.0) | 181 (68.6) | 156 (69.3) | |
Cardiovascular risk factors and comorbidities | ||||
Smokinga, n (%) | 5 (25.0) | 27 (10.2) | 19 (8.4) | 0.0712
|
Obesityb, n (%) | 8 (40.0) | 96 (36.5) | 80 (35.9) | 0.9322
|
LDL > = 2.6 mmol/L, n (%) | 8 (44.4) | 123 (49.0) | 88 (41.9) | 0.3242
|
Hypertensionc, n (%) | 3 (15.0) | 128 (48.7) | 94 (41.8) | 0.0072
|
Diabetes melltiusd, n (%) | 7 (35.0) | 102 (38.8) | 87 (39.4) | 0.9472
|
Chronic kidney diseasee, n (%) | 1 (5.0) | 51 (19.3) | 76 (34.7) | <0.0012
|
Measurements | ||||
BMI (kg/m2), median (IQR) | 27.7 (25.1–33.5) | 28.4 (26.3–31.1) | 28.7 (26.1–31.1) | 0.9263
|
Systolic BP (mmHg), median (IQR) | 119 (114–128) | 138 (126–152) | 133 (123–148) | <0.0013
|
Diastolic BP (mmHg), median (IQR) | 75 (66–80) | 81 (73–88) | 80 (73–86) | 0.0173
|
Heart rate (min-1), median (IQR) | 57 (55–64) | 61 (56–69) | 63 (58–70) | 0.0153
|
Sinus rhythm, n (%) | 20 (100) | 238 (93.0) | 186 (90.7) | 0.3682
|
LDL Cholesterol (mmol/L), median (IQR) | 2.6 (2.2–3.4) | 2.6 (2.1–3.1) | 2.5 (2.0–3.1) | 0.6233
|
HbA1c (%), median (IQR) | 5.6 (5.3–6.0) | 5.7 (5.5–6.3) | 5.8 (5.4–6.2) | 0.3763
|
NT-proBNP (pg/mL), median (IQR) | 76 (35–146) | 146 (78.5–312.5) | 245 (113.3–626.8) | <0.0013
|
Hs-TnT (pg/mL), median (IQR) | 6.1 (5.4–18.5) | 8.8 (6.6–11.8) | 10.0 (7.1–14.9) | 0.0123
|
Echocardiography
Heart Failure Stage | |||||
---|---|---|---|---|---|
Total | A | B | C | p | |
N (%) | 509 | 20 (3.9) | 264 (51.9) | 225 (44.2) | |
LVEF (%), median (IQR) | 58 (53–62) | 64 (58–67) | 59 (55–63) | 56 (50–61) | <0.0011
|
LVEF categories, n (%) | |||||
< 30% | 7 (1.4) | 0 | 2 (0.8) | 5 (2.3) | 0.0412
|
30–39% | 23 (4.5) | 0 | 10 (3.8) | 13 (6.1) | |
40–52% | 80 (15.6) | 1 (5.0) | 32 (12.1) | 43 (20.1) | |
> 52% | 402 (78.5) | 19 (95.0) | 220 (83.3) | 153 (71.5) | |
Wall motion abnormalities, n (%) | 138 (28.1) | 2 (10.0) | 59 (23.4) | 74 (35.7) | 0.0032
|
LVEDVI (ml/m2), median (IQR) | 60 (50–72) | 49 (40–56) | 60 (50–69) | 61 (53–79) | <0.0011
|
LV mass index (g/m2), median (IQR) | 93 (78–110) | 82 (64–95) | 92 (77–108) | 99 (82–120) | <0.0011
|
LAA (cm2), median (IQR) | 20 (17–23) | 18 (16–20) | 20 (17–23) | 20 (17–24) | 0.0381
|
E/e´, median (IQR) | 9 (7.2–11.4) | 6.8 (5.5–8.4) | 8.8 (7.2–10.8) | 9.5 (7.5–12.1) | <0.0011
|
Patient care
Guideline-adherence
Discharge | Study visit | p | |
---|---|---|---|
Beta blocker, n (%) | 210 (93.3) | 191 (84.9) | 0.0021
|
ACEi/ARB, n (%) | 197 (87.6) | 187 (83.1) | 0.1541
|
MRA, n (%) | 30 (13.3) | 19 (8.4) | 0.0431
|
Loop diuretic, n (%) | 66 (29.3) | 72 (32.0) | 0.4511
|
Thiazide diuretic, n (%) | 35 (15.6) | 42 (18.7) | 0.3821
|
Glycoside, n (%) | 12 (5.3) | 14 (6.2) | 0.6251
|
Left ventricular ejection fraction | <40% | 40–52% | >52% | p |
---|---|---|---|---|
N (%) | 18 (8.4) | 43 (20.1) | 153 (71.5) | |
Age year, mean (SD) | 69 (8.6) | 69 (9.3) | 67 (9.2) | 0.4091
|
Males, n (%) | 17 (94.4) | 36 (83.7) | 117 (76.5) | 0.162
|
NYHA class, n (%) | 0.1042
| |||
I | 5 (29.4) | 9 (21.4) | 53 (35.1) | |
II | 5 (29.4) | 20 (47.6) | 66 (43.7) | |
III | 5 (29.4) | 12 (28.6) | 30 (19.9) | |
IV | 2 (11.8) | 1 (2.4) | 2 (1.3) | |
Hs-TnT, median (IQR) | 14.3 (8.6–22.9) | 12.3 (8.1–17.8) | 8.9 (6.7–13.0) | 0.0013
|
NT-proBNP, median (IQR) | 783 (371.5–1960.5) | 495 (255.5–1061.8) | 189 (86.5–401.0) | <0.0013
|
Beta blocker, n (%) | 18 (100) | 38 (88.4) | 125 (81.7) | 0.0852
|
ACEi/ARB, n (%) | 16 (88.9) | 36 (83.7) | 125 (81.7) | 0.8722
|
MRA, n (%) | 3 (16.7) | 7 (16.3) | 7 (4.6) | 0.0112
|
Loop diuretic, n (%) | 12 (66.7) | 21 (48.8) | 35 (22.9) | <0.0012
|
Thiazide diuretic, n (%) | 2 (11.1) | 1 (2.3) | 37 (24.2) | 0.0012
|
Glycoside, n (%) | 3 (16.7) | 4 (9.3) | 7 (4.6) | 0.0742
|