Utilization and outcome of coronary revascularization and valve procedures in acute heart failure - an evaluation based on the classification from the European Society of Cardiology
a Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, 9038 Tromsø, Norway b Institute of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway *Corresponding author. Tel.: +47-97666411, fax: +47-77628298. E-mail address : Stig.Eggen.Hermansen{at}unn.no (S.E. H...
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| Veröffentlicht in: | Interactive cardiovascular and thoracic surgery 2008-10, Vol.7 (5), p.833-838 |
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| creator | Hermansen, Stig Eggen Hansen, Magna Roaldsen, Marius Muller, Stig How, Ole-Jakob Myrmel, Truls |
| description | a Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, 9038 Tromsø, Norway
b Institute of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
*Corresponding author. Tel.: +47-97666411, fax: +47-77628298. E-mail address : Stig.Eggen.Hermansen{at}unn.no (S.E. Hermansen).
Early invasive treatments in patients with acute heart failure (AHF) are critical components to improve outcome. We aimed to establish if such treatments were applied according to existing guidelines and also to assess the subsequent mortality in the complete AHF population. All patients with AHF admitted to the intensive care unit/coronary care unit during the years 2003–2004 ( n =302) were retrospectively reviewed and classified according to the European Society of Cardiology. Invasive revascularization was applied more frequently in patients with cardiogenic shock following acute coronary syndromes (78%, n =40) than in less severe AHF (58%, n =62, P |
| doi_str_mv | 10.1510/icvts.2008.175067 |
| format | Article |
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b Institute of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
*Corresponding author. Tel.: +47-97666411, fax: +47-77628298. E-mail address : Stig.Eggen.Hermansen{at}unn.no (S.E. Hermansen).
Early invasive treatments in patients with acute heart failure (AHF) are critical components to improve outcome. We aimed to establish if such treatments were applied according to existing guidelines and also to assess the subsequent mortality in the complete AHF population. All patients with AHF admitted to the intensive care unit/coronary care unit during the years 2003–2004 ( n =302) were retrospectively reviewed and classified according to the European Society of Cardiology. Invasive revascularization was applied more frequently in patients with cardiogenic shock following acute coronary syndromes (78%, n =40) than in less severe AHF (58%, n =62, P <0.05). Only 8% ( n =4) of eligible patients with acute coronary syndromes and cardiogenic shock were treated non-invasively. Valvular dysfunction was a precipitating factor for AHF in 15% ( n =38). Acute mitral regurgitation was treated surgically exclusively in patients with mechanical defects. In-hospital mortality rates for less severe AHF was 12%, cardiogenic shock 46% and postcardiotomy HF 32%. Invasively treated patients had lower in-hospital mortality in both cardiogenic shock (35% vs. 70%, P =0.006) and less severe AHF (6% vs.17%, P =0.042). The study revealed an appropriate use of invasive revascularization. The high mortality in patients with severe AHF indicates that more effective treatment options are needed in eligible patients.
Key Words: Heart failure; Shock; Cardiogenic; Myocardial revascularization; Mortality; Acute coronary syndrome; Heart valve disease</description><identifier>ISSN: 1569-9293</identifier><identifier>EISSN: 1569-9285</identifier><identifier>DOI: 10.1510/icvts.2008.175067</identifier><identifier>PMID: 18603542</identifier><language>eng</language><publisher>England: Eur Assoc Cardio Surg</publisher><subject>Acute Coronary Syndrome - complications ; Acute Coronary Syndrome - mortality ; Acute Coronary Syndrome - therapy ; Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary - utilization ; Coronary Artery Bypass - utilization ; Europe ; Female ; Guideline Adherence ; Heart Failure - etiology ; Heart Failure - mortality ; Heart Failure - therapy ; Heart Valve Diseases - complications ; Heart Valve Diseases - mortality ; Heart Valve Diseases - surgery ; Heart Valve Prosthesis Implantation - utilization ; Hospital Mortality ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Practice Guidelines as Topic ; Retrospective Studies ; Severity of Illness Index ; Shock, Cardiogenic - etiology ; Shock, Cardiogenic - mortality ; Shock, Cardiogenic - therapy ; Societies, Medical ; Time Factors ; Treatment Outcome</subject><ispartof>Interactive cardiovascular and thoracic surgery, 2008-10, Vol.7 (5), p.833-838</ispartof><rights>Published by European Association for Cardio-Thoracic Surgery. All rights reserved. 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c234t-98f664670d539f2152508027d4cd5175d2375b54ba2917024dddee0dc0a9c9c93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18603542$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hermansen, Stig Eggen</creatorcontrib><creatorcontrib>Hansen, Magna</creatorcontrib><creatorcontrib>Roaldsen, Marius</creatorcontrib><creatorcontrib>Muller, Stig</creatorcontrib><creatorcontrib>How, Ole-Jakob</creatorcontrib><creatorcontrib>Myrmel, Truls</creatorcontrib><creatorcontrib>European Society of Cardiology</creatorcontrib><title>Utilization and outcome of coronary revascularization and valve procedures in acute heart failure - an evaluation based on the classification from the European Society of Cardiology</title><title>Interactive cardiovascular and thoracic surgery</title><addtitle>Interact CardioVasc Thorac Surg</addtitle><addtitle>Interact Cardiovasc Thorac Surg</addtitle><description>a Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, 9038 Tromsø, Norway
b Institute of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
*Corresponding author. Tel.: +47-97666411, fax: +47-77628298. E-mail address : Stig.Eggen.Hermansen{at}unn.no (S.E. Hermansen).
Early invasive treatments in patients with acute heart failure (AHF) are critical components to improve outcome. We aimed to establish if such treatments were applied according to existing guidelines and also to assess the subsequent mortality in the complete AHF population. All patients with AHF admitted to the intensive care unit/coronary care unit during the years 2003–2004 ( n =302) were retrospectively reviewed and classified according to the European Society of Cardiology. Invasive revascularization was applied more frequently in patients with cardiogenic shock following acute coronary syndromes (78%, n =40) than in less severe AHF (58%, n =62, P <0.05). Only 8% ( n =4) of eligible patients with acute coronary syndromes and cardiogenic shock were treated non-invasively. Valvular dysfunction was a precipitating factor for AHF in 15% ( n =38). Acute mitral regurgitation was treated surgically exclusively in patients with mechanical defects. In-hospital mortality rates for less severe AHF was 12%, cardiogenic shock 46% and postcardiotomy HF 32%. Invasively treated patients had lower in-hospital mortality in both cardiogenic shock (35% vs. 70%, P =0.006) and less severe AHF (6% vs.17%, P =0.042). The study revealed an appropriate use of invasive revascularization. The high mortality in patients with severe AHF indicates that more effective treatment options are needed in eligible patients.
Key Words: Heart failure; Shock; Cardiogenic; Myocardial revascularization; Mortality; Acute coronary syndrome; Heart valve disease</description><subject>Acute Coronary Syndrome - complications</subject><subject>Acute Coronary Syndrome - mortality</subject><subject>Acute Coronary Syndrome - therapy</subject><subject>Acute Disease</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angioplasty, Balloon, Coronary - utilization</subject><subject>Coronary Artery Bypass - utilization</subject><subject>Europe</subject><subject>Female</subject><subject>Guideline Adherence</subject><subject>Heart Failure - etiology</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - therapy</subject><subject>Heart Valve Diseases - complications</subject><subject>Heart Valve Diseases - mortality</subject><subject>Heart Valve Diseases - surgery</subject><subject>Heart Valve Prosthesis Implantation - utilization</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Practice Guidelines as Topic</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Shock, Cardiogenic - etiology</subject><subject>Shock, Cardiogenic - mortality</subject><subject>Shock, Cardiogenic - therapy</subject><subject>Societies, Medical</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1569-9293</issn><issn>1569-9285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkcuOFCEUhonRODcfwI1h5cpquRRVxdJ0RsdkklnMzJrQcGoaQxUtlzbte_l-0lMddWlYQA7f_3M4P0JvKVlRQclHZ_Y5rRghw4r2gnT9C3RORScbyQbx8s9Z8jN0kdI3QqgknLxGZ3ToCBctO0e_HrPz7qfOLsxYzxaHkk2YAIcRmxDDrOMBR9jrZIrX8V9yr_0e8C4GA7ZESNjVuikZ8BZ0zHjUztc6biqNq4Mvi3ajE9R3Zpy3gI3XKbnRmeVujGF6rl-XGHZQhffBOMiHYz9rHa0LPjwdrtCrUfsEb077JXr8fP2wvmlu7758XX-6bQzjbW7kMHZd2_XECi5HRgUTZCCst62xok7MMt6LjWg3mknaE9ZaawGINURLUxe_RO8X3_rL7wVSVpNLBrzXM4SSVCdFzzgRFaQLaGJIKcKodtFNdXaKEnXMSj1npY5ZqSWrqnl3Mi-bCexfxSmcCnxYgFB2_-V3anbrnrY_XASVJu19dWcL3SuhBs75b3lHsJY</recordid><startdate>20081001</startdate><enddate>20081001</enddate><creator>Hermansen, Stig Eggen</creator><creator>Hansen, Magna</creator><creator>Roaldsen, Marius</creator><creator>Muller, Stig</creator><creator>How, Ole-Jakob</creator><creator>Myrmel, Truls</creator><general>Eur Assoc Cardio Surg</general><general>European Association for Cardio-Thoracic Surgery</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20081001</creationdate><title>Utilization and outcome of coronary revascularization and valve procedures in acute heart failure - an evaluation based on the classification from the European Society of Cardiology</title><author>Hermansen, Stig Eggen ; Hansen, Magna ; Roaldsen, Marius ; Muller, Stig ; How, Ole-Jakob ; Myrmel, Truls</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c234t-98f664670d539f2152508027d4cd5175d2375b54ba2917024dddee0dc0a9c9c93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Acute Coronary Syndrome - complications</topic><topic>Acute Coronary Syndrome - mortality</topic><topic>Acute Coronary Syndrome - therapy</topic><topic>Acute Disease</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angioplasty, Balloon, Coronary - utilization</topic><topic>Coronary Artery Bypass - utilization</topic><topic>Europe</topic><topic>Female</topic><topic>Guideline Adherence</topic><topic>Heart Failure - etiology</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - therapy</topic><topic>Heart Valve Diseases - complications</topic><topic>Heart Valve Diseases - mortality</topic><topic>Heart Valve Diseases - surgery</topic><topic>Heart Valve Prosthesis Implantation - utilization</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Practice Guidelines as Topic</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Shock, Cardiogenic - etiology</topic><topic>Shock, Cardiogenic - mortality</topic><topic>Shock, Cardiogenic - therapy</topic><topic>Societies, Medical</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hermansen, Stig Eggen</creatorcontrib><creatorcontrib>Hansen, Magna</creatorcontrib><creatorcontrib>Roaldsen, Marius</creatorcontrib><creatorcontrib>Muller, Stig</creatorcontrib><creatorcontrib>How, Ole-Jakob</creatorcontrib><creatorcontrib>Myrmel, Truls</creatorcontrib><creatorcontrib>European Society of Cardiology</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Interactive cardiovascular and thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hermansen, Stig Eggen</au><au>Hansen, Magna</au><au>Roaldsen, Marius</au><au>Muller, Stig</au><au>How, Ole-Jakob</au><au>Myrmel, Truls</au><aucorp>European Society of Cardiology</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utilization and outcome of coronary revascularization and valve procedures in acute heart failure - an evaluation based on the classification from the European Society of Cardiology</atitle><jtitle>Interactive cardiovascular and thoracic surgery</jtitle><stitle>Interact CardioVasc Thorac Surg</stitle><addtitle>Interact Cardiovasc Thorac Surg</addtitle><date>2008-10-01</date><risdate>2008</risdate><volume>7</volume><issue>5</issue><spage>833</spage><epage>838</epage><pages>833-838</pages><issn>1569-9293</issn><eissn>1569-9285</eissn><abstract>a Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, 9038 Tromsø, Norway
b Institute of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
*Corresponding author. Tel.: +47-97666411, fax: +47-77628298. E-mail address : Stig.Eggen.Hermansen{at}unn.no (S.E. Hermansen).
Early invasive treatments in patients with acute heart failure (AHF) are critical components to improve outcome. We aimed to establish if such treatments were applied according to existing guidelines and also to assess the subsequent mortality in the complete AHF population. All patients with AHF admitted to the intensive care unit/coronary care unit during the years 2003–2004 ( n =302) were retrospectively reviewed and classified according to the European Society of Cardiology. Invasive revascularization was applied more frequently in patients with cardiogenic shock following acute coronary syndromes (78%, n =40) than in less severe AHF (58%, n =62, P <0.05). Only 8% ( n =4) of eligible patients with acute coronary syndromes and cardiogenic shock were treated non-invasively. Valvular dysfunction was a precipitating factor for AHF in 15% ( n =38). Acute mitral regurgitation was treated surgically exclusively in patients with mechanical defects. In-hospital mortality rates for less severe AHF was 12%, cardiogenic shock 46% and postcardiotomy HF 32%. Invasively treated patients had lower in-hospital mortality in both cardiogenic shock (35% vs. 70%, P =0.006) and less severe AHF (6% vs.17%, P =0.042). The study revealed an appropriate use of invasive revascularization. The high mortality in patients with severe AHF indicates that more effective treatment options are needed in eligible patients.
Key Words: Heart failure; Shock; Cardiogenic; Myocardial revascularization; Mortality; Acute coronary syndrome; Heart valve disease</abstract><cop>England</cop><pub>Eur Assoc Cardio Surg</pub><pmid>18603542</pmid><doi>10.1510/icvts.2008.175067</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Interactive cardiovascular and thoracic surgery, 2008-10, Vol.7 (5), p.833-838 |
| issn | 1569-9293 1569-9285 |
| language | eng |
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| source | MEDLINE; Access via Oxford University Press (Open Access Collection); EZB-FREE-00999 freely available EZB journals |
| subjects | Acute Coronary Syndrome - complications Acute Coronary Syndrome - mortality Acute Coronary Syndrome - therapy Acute Disease Adult Aged Aged, 80 and over Angioplasty, Balloon, Coronary - utilization Coronary Artery Bypass - utilization Europe Female Guideline Adherence Heart Failure - etiology Heart Failure - mortality Heart Failure - therapy Heart Valve Diseases - complications Heart Valve Diseases - mortality Heart Valve Diseases - surgery Heart Valve Prosthesis Implantation - utilization Hospital Mortality Humans Kaplan-Meier Estimate Male Middle Aged Practice Guidelines as Topic Retrospective Studies Severity of Illness Index Shock, Cardiogenic - etiology Shock, Cardiogenic - mortality Shock, Cardiogenic - therapy Societies, Medical Time Factors Treatment Outcome |
| title | Utilization and outcome of coronary revascularization and valve procedures in acute heart failure - an evaluation based on the classification from the European Society of Cardiology |
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