Management of heart failure complicating acute coronary syndromes in Montenegro and Serbia

Abstract

Montenegro and Serbia with a diagnosis of ACS during the period between October 2012 and August 2013. Among 1115 patients, 94 (8.4%) had an admission diagnosis of HF (Killip Class II or III). Heart failure patients were significantly older (P , 0.001). Heart failure was more frequently associated with hypertension. When compared with patients presenting without HF (Killip Class I), those with HF had lower rates of reperfusion therapy either by percutaneous coronary intervention (47.9 vs. 60.7%, P ¼ 0.015) or by fibrinolysis (2.1 vs. 11.8%, P ¼ 0.004). In multivariate logistic regression analysis, older age, prior coronary artery bypass graft, and ST-segment elevation myocardial infarction were the relevant predictor of HF at admission. Heart failure on admission was associated with a marked increase in mortality rates during hospitalization (13.8 vs. 3.7%, P , 0.001). After adjustment for differences in clinical characteristics, HF was still associated with higher mortality (odds ratio 2.88, 95% confidence interval 1.22-6.79, P ¼ 0.016). Heart failure is observed in nearly 9% of patients with ACS in Serbia and Montenegro and is also associated with a significant increase in in-hospital mortality. More aggressive treatment of these patients is warranted to improve prognosis.

Heart failure in non ST-elevation myocardial infarction (NSTEMI) patients presenting in Faisalabad Institute of Cardiology.

“…It was found in one study that Survival is higher in patients without congestive heart failure than with congestive heart failure patients. 9,10 Ahit MC, et al reported the 10.6% frequency of HF in NSTEMI patients with old age, female gender, very high heart rate, higher presenting heart rate, diabetes, hypertension and previous history of MI are significant risk factors noted. 11,12 Kaul P, et al reported 13.6% patient of HF in STEMI and 14.8% patients of HF with NSTEMI (P < .01).…”