PT  - JOURNAL ARTICLE
AU  - Ferreira, João Pedro
AU  - Rossignol, Patrick
AU  - Demissei, Biniyam
AU  - Sharma, Abhinav
AU  - Girerd, Nicolas
AU  - Anker, Stefan D
AU  - Cleland, John G
AU  - Dickstein, Kenneth
AU  - Filippatos, Gerasimos
AU  - Hillege, Hans L
AU  - Lang, Chim C
AU  - Metra, Marco
AU  - Ng, Leong L
AU  - Ponikowski, Piotr
AU  - Samani, Nilesh J
AU  - van Veldhuisen, Dirk J
AU  - Zwinderman, Aeilko H
AU  - Voors, Adriaan
AU  - Zannad, Faiez
TI  - Coronary angiography in worsening heart failure: determinants, findings and prognostic implications
AID  - 10.1136/heartjnl-2017-311750
DP  - 2018 Apr 01
TA  - Heart
PG  - 606--613
VI  - 104
IP  - 7
4099  - http://heart.bmj.com/content/104/7/606.short
4100  - http://heart.bmj.com/content/104/7/606.full
SO  - Heart2018 Apr 01; 104
AB  - Objectives Coronary angiography is regularly performed in patients with worsening signs and/or symptoms of heart failure (HF). However, little is known on the determinants, findings and associated clinical outcomes of coronary angiography performed in patients with worsening HF.Methods The BIOSTAT-CHF (a systems BIOlogy Study to TAilored Treatment in Chronic Heart Failure) programme enrolled 2516 patients with worsening symptoms and/or signs of HF, either hospitalised or in the outpatient setting. All patients were included in the present analysis.Results Of the 2516 patients included, 315 (12.5%) underwent coronary angiography within the 30 days after the onset of worsening symptoms and/or signs of HF. Subjects who underwent angiography were more often observed as inpatients, had more often an overt acute coronary syndrome, had higher troponin I levels, were younger and had better renal function (all p≤0.01). Patients who underwent coronary angiography had a lower risk of the primary outcome of death and/or HF hospitalisation (adjusted HR=0.71, 95% CI 0.57 to 0.89, p=0.003) and death (adjusted HR=0.59, 95% CI 0.43 to 0.80, p=0.001). Among the patients who underwent coronary angiography, those with a coronary stenosis (39%) had a worse prognosis than those without stenosis (adjusted HR for the primary outcome=1.71, 95% CI 1.10 to 2.64, p=0.016).Conclusions Coronary angiography was performed in <13% of patients with symptoms and/or signs of worsening HF. These patients were remarkably different from those who did not undergo coronary angiography and had a lower risk of subsequent events. The presence of coronary stenosis on coronary angiography was associated with a worse prognosis.