Management of heart failure complicating acute coronary syndromes in Montenegro and Serbia
Por:
Knezevic, B, Vasiljevic, Z, Music, L, Krivokapic, L, Ljubic, V, Tomic, SC, Omer, S, Radojicic, S, Radoman, C, Rajovic, G, Riger, L, Saranovic, M, Velickovic, M, Rajic, D, Zivkovic, S, Lasica, R, Bankovic-Milenkovic, N, Ljubica, D, Jovanovic, D, Jelica, M, Radakovic, G, Zdravkovic, M, Ricci, B, Manfrini, O, Martelli, I, Koller, A, Badimon, L, Bugiardini, R
Publicada:
1 ene 2014
Resumen:
It is essential that context-appropriate health research and health interventions take place in countries with economy in transition. The aims of this study were to describe the clinical characteristics, management, and in-hospital outcomes of acute coronary syndrome (ACS) patients with heart failure (HF) in Montenegro and Serbia. The data of this study are a framework of the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-TC; NCT01218776), a multi-national and multicentre registry of patients hospitalized with ACS in the European countries that emerged from the Socialist era. The present analysis focused on participants admitted to 15 hospitals in 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 = 0.015) or by fibrinolysis (2.1 vs. 11.8%, P = 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 = 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.
Filiaciones:
Knezevic, B:
Ctr Cardiol, Clin Ctr Montenegro, Podgorica 82000, Montenegro
Vasiljevic, Z:
Fac Med Belgrade, Univ Clin, Clin Ctr Serbia, Clin Cardiol, Belgrade 11000, Serbia
Music, L:
Ctr Cardiol, Clin Ctr Montenegro, Podgorica 82000, Montenegro
Krivokapic, L:
Gen Hosp Kotor, Kotor, Montenegro
Ljubic, V:
Gen Hosp Berane, Berane, Montenegro
Tomic, SC:
Gen Hosp Pljevlja, Pljevlja, Montenegro
Omer, S:
JZU Dom Zdravlja Plav, Plav, Montenegro
Radojicic, S:
Gen Hosp Danilo I, Cetinje, Montenegro
Radoman, C:
Gen Hosp Pljevlja, Pljevlja, Montenegro
Rajovic, G:
Gen Hosp Meljine, Herceg Novi, Montenegro
Riger, L:
Ctr Cardiol, Clin Ctr Montenegro, Podgorica 82000, Montenegro
Saranovic, M:
Gen Hosp Pljevlja, Pljevlja, Montenegro
Velickovic, M:
Gen Hosp Bijelo, Polje, Montenegro
Rajic, D:
Fac Med Belgrade, Univ Clin, Clin Ctr Serbia, Clin Cardiol, Belgrade 11000, Serbia
Zivkovic, S:
Gen Hosp Cuprija, Cuprija, Serbia
Lasica, R:
Fac Med Belgrade, Univ Clin, Clin Ctr Serbia, Clin Cardiol, Belgrade 11000, Serbia
Bankovic-Milenkovic, N:
Gen Hosp Surdulica, Surdulica, Serbia
Ljubica, D:
Gen Hosp Krusevac, Krusevac, Serbia
Jovanovic, D:
Gen Hosp Leskovac, Leskovac, Serbia
Jelica, M:
Gen Hosp Jagodina, Jagodina, Serbia
Radakovic, G:
Gen Hosp Sabac, Sabac, Serbia
Zdravkovic, M:
Clin Hosp Ctr Bezanijska Kosa, Belgrade, Serbia
Ricci, B:
Univ Bologna, Dept Expt Diagnost & Specialized Med, Cardiol Sect, Bologna, Italy
Manfrini, O:
Univ Bologna, Dept Expt Diagnost & Specialized Med, Cardiol Sect, Bologna, Italy
Martelli, I:
Univ Bologna, Dept Expt Diagnost & Specialized Med, Cardiol Sect, Bologna, Italy
Koller, A:
Univ Pecs, Szentagothai Res Ctr, Dept Pathophysiol & Gerontol, Pecs, Hungary
Badimon, L:
Autonomous Univ Barcelona, Cardiovasc Res Ctr, CSIC ICCC, Hosp Santa Creu & St Pau,CiberObn Inst Carlos 3, Barcelona, Spain
Bugiardini, R:
Univ Bologna, Dept Expt Diagnost & Specialized Med, Cardiol Sect, Bologna, Italy
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