P81 IMPACT OF CORONAROGRAPHY AND CORONARY ANGIOPLASTY ON MORTALITY IN A COHORT OF PATIENTS WITH NEW–ONSET HEART FAILURE IN ITALY

Abstract Background Although myocardial ischemia and coronary artery disease play a crucial role in the pathophysiology of new–onset heart failure (HF), the impact of coronary angiography and percutaneous coronary angioplasty (PCI) revascularization on HF mortality is not well clarified. Objective To evaluate the efficacy of performing coronary angiography and PCI in reducing medium–term outcomes in a cohort of patients hospitalized with new–onset HF in Italy. Methods Retrospective cohort study enrolling all patients aged 18–100 years hospitalized for new–onset heart failure in an Italian accredited public or private hospital in the years 2015–2019 and survived 30 days after index hospitalization. Patients with a prior diagnosis of CAD were excluded from the analysis. The enrolled patients were classified into: patients not undergoing coronary angiography (No CVG); patients undergoing coronary angiography without PCI (CORO) and patients undergoing coronary angiography and PCI (PCI). The primary outcome measure of the study was all–cause mortality 1 year after the index hospitalization. A multivariate Cox model estimated through a stepwise procedure was used to compare the study groups taking into account the different distribution of risk factors. Results 342,090 hospitalizations for new–onset HF were recorded in Italy during the study period. Of these, 32,240 (9.42%) patients underwent coronary angiography without PCI and only 5,890 (1.72%) underwent PCI as well. Patients undergoing an invasive procedure were on average younger (mean age =80.7 in No CVG, 69.0 in CORO and 72.3 in PCI), with a lower percentage of women (58.8% in No CVG, 37.0% in CORO and 27.6% in PCI) and with fewer comorbidities than untreated. After adjusting for gender, age, and comorbidities, coronary angiography was protective versus no treatment whether performed alone (HR=0.57; p