Incident Heart Failure in Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

Abstract

Background: The contemporary incidence of heart failure (HF) in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) remains unclear. This prospective cohort study was designed to study the incidence and predictors of new-onset HF in CAD patients after PCI (ChiCTR1900023033).Methods: From January 2014 to December 2018, 3,910 CAD patients without HF history undergoing PCI were prospectively enrolled. Demographics, medical history, cardiovascular risk factors, cardiac parameters, and medication data were collected at baseline. Multivariable adjusted competing-risk regression analysis was performed to examine the predictors of incident HF.Results: After a median follow-up of 63 months, 497 patients (12.7%) reached the primary endpoint of new-onset HF, of which 179, 110, and 208 patients (36.0, 22.1, and 41.9%) were diagnosed as having HF with reduced ejection fraction (EF) (HFrEF), HF with mid-range EF (HFmrEF), and HF with preserved EF (HFpEF), respectively. Higher B-type natriuretic peptide (BNP) or E/e′ level, lower estimated glomerular filtration rate (eGFR) level, and atrial fibrillation were the independent risk factors of new-onset HF. Gender (male) and angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker (ACEI/ARB) prescription were the negative predictors of new-onset HF. Moreover, it was indicated that long-term ACEI/ARB therapy, instead of beta-blocker use, was linked to lower risks of development of all three HF subtypes (HFrEF, HFmrEF and HFpEF).Conclusions: This prospective longitudinal cohort study shows that the predominant subtype of HF after PCI is HFpEF and ACEI/ARB therapy is accompanied with reduced risks of incident HF across three subtypes.

[Retracted] The Expression Significance of LPa, BNP, and McP‐1 in CHD Patients and Their Relationship with Echocardiographic Parameters

“…In recent years, studies have shown that monocyte chemotactic Protein-1 (McP-1), as a kind of factor mediating the formation of foam cells in monocytes, also plays a role in the inflammatory response of atherosclerosis [ 6 ]. B-type natriuretic peptide, as one of the related hormones secreted by cardiomyocytes, also plays an important role in predicting adverse cardiovascular events [ 7 ]. In addition, as a blood lipid index, Lipoprotein A (LPa) may also play a certain role in the development of coronary heart disease [ 8 ], but there are relatively few studies on the above indexes.…”

Chronic Kidney Disease Increases Risk of Incident HFrEF Following Percutaneous Coronary Intervention

“…On the other hand, the CKD group was less likely to receive ACEI/ARB. Previous studies have also shown that ACEI/ARB therapy was accompanied with reduced risks of incident HF (2,22). Moreover, there are some pathophysiologic mechanisms to account for the adverse effect of CKD on incident HFrEF.…”

“…Coronary artery disease (CAD) is the most common cause of heart failure (HF) (1). Even after percutaneous coronary intervention (PCI), patients with CAD still have a high risk of incident heart failure with reduced ejection fraction (HFrEF) (2). Thus, it is necessary to identify risk factors and improve prognosis among patients with CAD undergoing PCI.…”

The impact of serum BNP on retinal perfusion assessed by an AI-based denoising optical coherence tomography angiography in CHD patients

“…BNP is synthesized in the heart ventricles, and increase during ventricular dysfunction. Higher BNP was an independent risk factor of new-onset HF [ 4 , 5 ].…”