心力衰竭对中国急性冠脉综合征患者院内结局的影响——来自中国冠心病二级预防架桥工程(BRIG)项目的结果

Zhao, D.; Capital Medical University, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Andingmenwai Anzhenli, Chaoyang District, Beijing 100029, China; email:deezhao@vip.sina.com

Background: Treatments of acute coronary syndrome (ACS) and heart failure (HF) have progressed greatly in the past decades. However, few data are currently available regarding the impact of HF on the in-hospital outcomes of ACS patients, under current treatment status, in China. Methods: A total of 65 hospitals from all 31 provinces of mainland China and the Hong Kong special administrative region were recruited using a multistage non-randomized sampling approach. A questionnaire was completed according to the medical records of 3168 ACS patients, of which 706 (22.3%) had acute HF and 262 (8.3%) HF patients did not have an episode of acute HF during hospitalization. Results: The rates of in-hospital mortality and composite end-point events (death, myocardial re-/infarction, serious arrhythmia and stroke) of acute HF patients were significantly higher than those of HF patients without an acute episode and patients without HF. After adjustment for other factors (including age, ACS types and in-hospital treatments, etc.), acute HF remained to be a potent independent predictor of in-hospital mortality and composite end-point events for ACS patients (OR = 7.50, 95% CI = 4.32-13.02 and OR = 2.74, 95% CI = 2.15-3.48, respectively). The utilization rates of guideline recommended treatments for ACS complicating HF, such as β-blockers (67.6%) and PCI (17.4%), were low in the acute HF patients. Conclusions: Under current treatment status, acute HF during hospitalization still rendered higher rates of in-hospital mortality and composite end-point events in the studied ACS patients in China. © 2011 Elsevier Ireland Ltd.

Division of Cardiology, Capital Medical University, Beijing Tiantan Hospital, Beijing, China