title: Outcomes of acute heart failure associated with acute coronary syndrome versus other causes.
abstract: BACKGROUND
  By and large, prior registries and randomized trials have not distinguished between acute heart failure (AHF) associated with acute coronary syndrome (ACS) versus other causes.
  
  
  OBJECTIVE
  To examine whether the treatments and outcomes of ACS-associated AHF are different from non-ACS-associated AHF.
  
  
  METHODS
  We examined in a prospective, nationwide hospital-based survey the adjusted outcomes of AHF patients with and without ACS as its principal cause.
  
  
  RESULTS
  Of the 4102 patients in our national heart failure survey, 2336 (56.9%) had AHF, of whom 923 (39.5%) had ACS-associated AHF. These patients were more likely to receive intravenous inotropes and vasodilators and to undergo coronary angiography and revascularization, but less likely to receive intravenous diuretics. The unadjusted in-hospital, 30-day, one-year, and four-year mortality rates for AHF patients with or without ACS were 6.5% versus 5.0% (P = 0.13), 10.3% versus 7.5% (P = 0.02), 26.6% versus 31.0% (P = 0.02), and 55.3% versus 63.3% (P = 0.0001), respectively. In the multivariate analysis, the adjusted mortality risk for patients with ACS at the respective time points were 1.46 (0.99-2.10), 1.67 (1.22-2.30), 1.02 (0.86-1.20), and 0.93 (0.82-1.04).
  
  
  CONCLUSIONS
  Patients with ACS-associated AHF seem to have a unique clinical course and perhaps should be distinguished from other AHF patients in future trials and registries.
authors.affiliation: Lea Wiessman Clinical Cardiology Research Center, Department of Cardiology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Greenberg
authors.forename: Eytan
authors.initials: E
authors.lastname: Cohen
authors.forename: Moshe
authors.initials: M
authors.lastname: Garty
authors.forename: Zaza
authors.initials: Z
authors.lastname: Iakobishvili
authors.forename: Amir
authors.initials: A
authors.lastname: Sandach
authors.forename: Solomon
authors.initials: S
authors.lastname: Behar
authors.forename: Avraham
authors.initials: A
authors.lastname: Shotan
authors.forename: Shmuel
authors.initials: S
authors.lastname: Gottlieb
authors.forename: Aviv
authors.initials: A
authors.lastname: Mager
authors.forename: Alexander
authors.initials: A
authors.lastname: Battler
authors.forename: David
authors.initials: D
authors.lastname: Hasdai
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006306:Health Surveys; D006333:Heart Failure / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009204:Myocardial Revascularization; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D004232:Diuretics; D014665:Vasodilator Agents