Clinical Characteristics and Outcomes of Patients With Coronary Artery Disease and Angina

Badar, Athar A.; Moreno, Ana Cristina Perez; Hawkins, Nathaniel M.; Jhund, Pardeep S.; Brunton, Alan; Anand, Inder S.; McKelvie, Robert S.; Komajda, Michel; Zile, Michael R.; Carson, Peter E.; Gardner, Roy S.; Petrie, Mark C.; McMurray, John J.V.

doi:10.1161/circheartfailure.114.002024

Cited by 21 publications

(3 citation statements)

References 17 publications

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“…The “Irbesartan in Heart Failure with Preserved systolic function (I-Preserve)” study included 4.128 patients with HFpEF from different geographical regions (27). In the I-Preserve study, patients from different geographic regions had different clinical characteristics.…”

Section: Discussionmentioning

confidence: 99%

Geographical Variations in Patients with Heart Failure and Preserved Ejection Fraction: A Sub-Group Analysis of the APOLLON Registry

Özlek

Ağuş

et al. 2019

Balkan Med J

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Background: Clinical characteristics of patients with heart failure may vary geographically. However, limited data are available regarding the geographical differences of patients with heart failure and preserved ejection fraction. Aims: The present subgroup analysis aims to investigate the geographical differences in clinical characteristics, management, and primary etiology of patients with heart failure and preserved ejection fraction in Turkey. Study Design: A cross-sectional study. Methods: A comPrehensive, ObservationaL registry of heart faiLure with mid-range and preserved ejection fractiON (APOLLON) is a multicenter and observational study conducted in seven regions of Turkey (NCT03026114). The present study is a post-hoc analysis of the APOLLON registry. In this substudy, we compared the clinical characteristics of 819 consecutive patients with heart failure and preserved ejection fraction (mean age, 67 years; 57.8% women) admitted to cardiology outpatient units in different geographical regions. Results: Based on the geographical distribution of the entire Turkish population, the highest number of patients enrolled were from Marmara (271 patients, 33.1%). All demographical characteristics, clinical and laboratory findings, comorbidities, primary etiology, and medications prescribed were significantly different between the regions. Furthermore, interregional gender differences were identified. Comparatively, the Aegean and Mediterranean regions had older patients with heart failure and preserved ejection fraction (p<0.001), and the Black Sea, Southeast, and East Anatolia regions had predominantly male patients (51.2, 54.5, and 56.9%, respectively; p=0.002). Notably, the Mediterranean and Southeast Anatolia had more symptomatic patients, and history of hospitalization for heart failure was more prevalent in Southeast Anatolia (33.3%, p<0.001). Prevalence of atrial fibrillation was higher in the Mediterranean and Southeast Anatolia regions (51 and 48.5%, p<0.001), and patients with heart failure and preserved ejection fraction had a higher prevalence of hypertension in the Mediterranean, Southeast Anatolia, and Black Sea regions (p=0.002). Angiotensin-converting enzyme inhibitors were more frequently prescribed in East Anatolia (52.3%, p=0.001), and the prevalence of patients with heart failure and preserved ejection fraction using loop diuretics (48.8%, p=0.003) was higher in the Black Sea region. Conclusion: This study was the first to show geographical differences in clinical characteristics of patients with heart failure and preserved ejection fraction in Turkey. Determination of the clinical characteristics of the heart failure and preserved ejection fraction population based on the geographical region may enables physicians to adopt a regionspecific clinical approach toward heart failure and preserved ejection fraction.

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Section: Discussionmentioning

confidence: 99%

Geographical Variations in Patients with Heart Failure and Preserved Ejection Fraction: A Sub-Group Analysis of the APOLLON Registry

Özlek

Ağuş

et al. 2019

Balkan Med J

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“…After adjustment for common cardiac comorbidities, CAD was a risk factor for incident HFpEF in the Atherosclerosis Risk in Communities (ARIC) study [122]. Patients with CAD and HFpEF were at higher risk of all-cause mortality and sudden cardiac death than their counterparts without CAD in the Irbesartan in HFpEF (I-PRESERVE) study [123].…”

Section: Coronary Artery Diseasementioning

confidence: 99%

Obesity, Preserved Ejection Fraction Heart Failure, and Left Ventricular Remodeling

Stencel

Alai

Dhorepatil

et al. 2023

JCM

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Owing to the overwhelming obesity epidemic, preserved ejection fraction heart failure commonly ensues in patients with severe obesity and the obese phenotype of preserved ejection fraction heart failure is now commonplace in clinical practice. Severe obesity and preserved ejection fraction heart failure share congruent cardiovascular, immune, and renal derangements that make it difficult to ascertain whether the obese phenotype of preserved ejection fraction heart failure is the convergence of two highly prevalent conditions or severe obesity enables the development and progression of the syndrome of preserved ejection fraction heart failure. Nevertheless, the obese phenotype of preserved ejection fraction heart failure provides a unique opportunity to assess whether sustained and sizeable loss of excess body weight via metabolic bariatric surgery reverses the concentric left ventricular remodeling that patients with preserved ejection fraction heart failure commonly display.

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“…Depressed left ventricular function (LVF) is likely, whether myocardial ischemia is owing to compromised function of large epicardial vessels [ 3 ] or the microcirculation of the heart [ 4 , 5 ]. The presence of clinical features of myocardial ischemia usually indicates coronary artery disease (CAD) [ 6 ]. In such patients, failure of the coronary angiography to demonstrate apparent, or induced, narrowing of the large coronary vessels redirects the possible diagnosis towards microvascular ischemia of the myocardium.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of resting left ventricular akinesia/hypokinesia in predicting abnormal coronary angiography

Lutfi

2016

BMC Cardiovasc Disord

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BackgroundAlthough several reports demonstrate the efficacy of stress echocardiography in diagnosing coronary artery disease, comparable studies on the competence of the same imaging technique at rest are limited. This study aimed to evaluate whether ventricular akinesia/hypokinesia and left ventricular ejection fraction (LVEF) < 55 % at rest are useful in predicting abnormal coronary angiography.MethodsThis study prospectively enrolled 100 diagnostic coronary catheterization candidates. Any routine echocardiography that the candidates had undergone before diagnostic coronary catheterization was reviewed. Patients were subclassified according to the presence and location of ventricular akinesia/hypokinesia, LVEF, and the results of diagnostic coronary catheterization. LVEF < 55 % was considered below the normal physiological limit. Abnormal coronary angiography was defined as narrowing of half or more of the caliber of at least one major coronary artery.ResultsAbnormal coronary angiography was significantly associated with akinesia/hypokinesia (OR = 4.85, P = 0.002) and LVEF < 55 % (OR = 5.75, P = 0.001). Screening of akinesia/hypokinesia and LVEF < 55 % as diagnostic tools for abnormal coronary angiography achieved comparable sensitivities (87.2 % vs. 88.9 %), specificities (41.5 vs. 41.8), and diagnostic accuracies (41.5 vs. 41.8). Left ventricular anterior wall akinesia/hypokinesia achieved a higher diagnostic odds ratio (9.7), sensitivity (95 %), and negative predictive value (96.4 %) compared with other types of akinesia/hypokinesia.ConclusionThe overall diagnostic accuracy of akinesia/hypokinesia and LVEF < 55 % to predict abnormal coronary angiography was poor, probably owing to significant influences of macro- as well as micro-vascular ischemia on left ventricular function.

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Clinical Characteristics and Outcomes of Patients With Coronary Artery Disease and Angina

Cited by 21 publications

References 17 publications

Geographical Variations in Patients with Heart Failure and Preserved Ejection Fraction: A Sub-Group Analysis of the APOLLON Registry

Geographical Variations in Patients with Heart Failure and Preserved Ejection Fraction: A Sub-Group Analysis of the APOLLON Registry

Obesity, Preserved Ejection Fraction Heart Failure, and Left Ventricular Remodeling

Diagnostic accuracy of resting left ventricular akinesia/hypokinesia in predicting abnormal coronary angiography

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