A Simple Validated Clinical Tool to Predict the Absence of Coronary Artery Disease in Patients With Systolic Heart Failure of Unclear Etiology

Doukky, Rami; Shih, Michael J.; Rahaby, Mouyyad; Alyousef, Tareq; Abusin, Salaheldin; Ansari, Najamul; Kelly, Russell F.

doi:10.1016/j.amjcard.2013.05.078

Cited by 14 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results corroborate previous observations, showing similar rates of CAD in HFrEF patients without angina [4,10]. In our study, although patients with significant CAD had a higher prevalence of CVRF they were not statistically significantly different from patients without CAD.…”

supporting

confidence: 92%

“…According to the 2014 guidelines on myocardial revascularization, CA continues to be the gold standard for the assessment of CAD severity [2,3,9]. Some authors propose routine angiography in all patients with HFrEF, because the presence of CAD is not uncommon among patients with HF of unknown etiology [10]. In our population of 168 patients with HFrEF and no angina, the prevalence of angiographically significant CAD was high (31%).…”

mentioning

confidence: 77%

“…Independent predictors of severe CAD included DM, electrocardiographic Q waves or left bundle branch block and at least two nondiabetic risk factors. The presence of at least one of these factors identified more than 95% of CAD cases and all of the patients with severe disease [10]. This study, as ours, was limited, by having included only those patients who had undergone angiography.…”

mentioning

confidence: 97%

See 2 more Smart Citations

Heart failure with reduced ejection fraction: Should we submit patients without angina to coronary angiography?

Silva

Borges

Ribeiro

et al. 2015

International Journal of Cardiology

View full text Add to dashboard Cite

supporting

confidence: 92%

mentioning

confidence: 77%

mentioning

confidence: 97%

See 1 more Smart Citation

Heart failure with reduced ejection fraction: Should we submit patients without angina to coronary angiography?

Silva

Borges

Ribeiro

et al. 2015

International Journal of Cardiology

View full text Add to dashboard Cite

“…But this higher prevalence reports are from series, which included patients with past coronary events like MI, Q waves on ECG and previous revascularization. Upon comparison with studies of CAD prevalence including cohorts with unexplained heart failure, our prevalence figures are similar 16 . Some publications also used a coronary stenosis of ≥ 50% to define significant CAD, which would explain a higher prevalence of CAD.…”

Section: Discussionsupporting

confidence: 61%

Coronary Artery Disease prevalence in Heart Failure with Reduced Ejection Fraction

et al. 2019

View full text Add to dashboard Cite

Background and Aims: Even though heart failure (HF) is a major global health problem, studies on the prevalence and etiology of HF in Nepal are scant. Coronary artery disease (CAD) has been reported to be the etiology in 18% of HF presentations to the emergency department of a tertiary cardiac center in Nepal1. Present study evaluated the prevalence and characteristics of CAD in HF with reduced ejection fraction (HFrEF) with coronary angiography (CAG). Methods: In a prospective, observational study, conducted from June 2018 to May 2019, 95 patients with HFrEF undergoing CAG, at Shahid Gangalal National Heart Centre, were evaluated. Results: The mean age of the patients was 62.7±10.1 years, with 67% males. Obstructive CAD was present in 31(33%) with 48%, 39% and 13% having triple (TVD), single (SVD) and double vessel disease (DVD) respectively. Age ≥ 65 years, smokers, dyslipidemia, obesity, angina, indexed left ventricular end diastolic volume (iEDV), indexed LV systolic diameter (iLVIDs) and regional wall motion abnormality (RWMA) on echocardiography were predictors of CAD, among only which, smoking was the independent predictor of CAD. Conclusion: Our results suggest a lower prevalence of CAD in HFrEF than previously reported from developed countries, which may be due to a systematic angiography approach and exclusion of previous coronary events. We encourage clinicians to aggressively identify this co-morbidity as it has important treatment and prognostic implementations.

show abstract

“…A study discussing cardiovascular risk factors and the presence of coronary artery disease (CAD) in patients with severe systolic dysfunction was recently published. The authors conclude that their analysis for the prediction of CAD is a tool with high sensitivity (98%) but low specificity (18%) [4]. It is not clear the real value of coronarography in patients undergoing to the catheterization laboratory with dyspnoea and left ventricular Ejection Fraction (LVEF) less than 35% in the daily practice, even when CAD was suspected.…”

Section: Introductionmentioning

confidence: 94%

Role of coronary angiography in severe left ventricular systolic dysfunction and dyspnoea. Do we really follow the guidelines?

Bayón¹,

Santás-Álvarez²,

Ocaranza-Sánchez³

et al. 2017

Interventional-Cardiology

View full text Add to dashboard Cite

Introduction: Role of coronary angiography is not well established in left ventricular dysfunction patients coming with dyspnoea. The aim of our study is to evaluate in a 8 year retrospective sample of patients with severe systolic dysfunction and suspicion of underlying coronary artery disease, the diagnostic value of coronary angiography in relation to the patient's clinical and traditional cardiovascular risk factors. Methods: We analyse 1022 patients observing coronary disease in 288 (28.2%) and risk factors show that diabetes, smoking, male gender and age above 65 years are the most powerful predictors of coronary disease. Results: Regarding the extent of CAD, classic cardiovascular risk factors contributes significantly in those patients with a single coronary vessel disease, probable incidental finding without being responsible for systolic dysfunction. Only diabetes and gender male reach statistical significance as independent predictors in the three-vessel disease, where the CAD actually plays a role in the pathogenesis of systolic left ventricular dysfunction. Conclusions: The results of our work invited to question the need for coronary angiography only in certain groups of patients, based on their cardiovascular risk profile as part of the study of severe left ventricular systolic dysfunction.

show abstract

A Simple Validated Clinical Tool to Predict the Absence of Coronary Artery Disease in Patients With Systolic Heart Failure of Unclear Etiology

Cited by 14 publications

References 21 publications

Heart failure with reduced ejection fraction: Should we submit patients without angina to coronary angiography?

Heart failure with reduced ejection fraction: Should we submit patients without angina to coronary angiography?

Coronary Artery Disease prevalence in Heart Failure with Reduced Ejection Fraction

Role of coronary angiography in severe left ventricular systolic dysfunction and dyspnoea. Do we really follow the guidelines?

Contact Info

Product

Resources

About