title: Incidence, risk factors, and prognosis of inhospital heart failure after percutaneous coronary intervention: insight from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2).
abstract: BACKGROUND
  Prior history of heart failure (HF) has been shown to be a predictor of poor outcomes after percutaneous coronary intervention (PCI). Clinical predictors of the development of inhospital HF and its prognostic significance after PCI have yet to be defined. In this study, we sought to identify the incidence, risk factors, and prognosis of inhospital HF after PCI.
  
  
  METHODS
  Using a contemporary registry of consecutive PCIs, the incidence of HF after PCI was identified. Multivariate logistic regression analysis was used to determine predictors of the development of HF after PCI as well as the impact of HF on inhospital mortality.
  
  
  RESULTS
  The incidence of HF after PCI in the overall patient population was 1.4%. Independent predictors of HF were female sex, age > or = 60 years, exceeding a maximum weight- and creatinine-adjusted contrast dose, diabetes, prior HF, prior gastrointestinal bleeding, prior chronic obstructive pulmonary disease, history of atrial fibrillation, American College of Cardiology type B2 or C vessel, emergency PCI, ejection fraction < 50%, myocardial infarction with or without cardiogenic shock, and repeat angiography. After adjustment for comorbidities, the development of HF was independently associated with an increased risk of inhospital death (adjusted OR 2.48, 95% CI 1.77-3.48).
  
  
  CONCLUSIONS
  The development of HF is a relatively uncommon occurrence after PCI and is associated with a poor prognosis. The identification of risk factors for HF could foster the development of interventions aimed toward its prevention in high-risk patients.
authors.affiliation: Division of Cardiology, Oakwood Hospital, Dearborn, Michigan, USA.
authors.forename: Rabeea
authors.initials: R
authors.lastname: Aboufakher
authors.forename: Arthur
authors.initials: A
authors.lastname: Riba
authors.forename: Sandeep M
authors.initials: SM
authors.lastname: Jani
authors.forename: Raj
authors.initials: R
authors.lastname: Goswami
authors.forename: Steven
authors.initials: S
authors.lastname: Schwartz
authors.forename: Sandra
authors.initials: S
authors.lastname: Lins
authors.forename: Julius
authors.initials: J
authors.lastname: Gardin
authors.forename: Dean E
authors.initials: DE
authors.lastname: Smith
authors.forename: Eva
authors.initials: E
authors.lastname: Kline-Rogers
authors.forename: David
authors.initials: D
authors.lastname: Share
authors.forename: Mauro
authors.initials: M
authors.lastname: Moscucci
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012307:Risk Factors