%0 Journal Article %A Ferreira, João Pedro %A Rossignol, Patrick %A Demissei, Biniyam %A Sharma, Abhinav %A Girerd, Nicolas %A Anker, Stefan D. %A Cleland, John G. %A Dickstein, Kenneth %A Filippatos, Gerasimos %A Hillege, Hans L. %A Lang, Chim C. %A Metra, Marco %A Ng, Leong L. %A Ponikowski, Piotr %A Samani, Nilesh J. %A van Veldhuisen, Dirk J. %A Zwinderman, Aeilko H. %A Voors, Adriaan %A Zannad, Faiez %D 2017 %T Coronary angiography in worsening heart failure: determinants, findings and prognostic implications. %U https://figshare.le.ac.uk/articles/journal_contribution/Coronary_angiography_in_worsening_heart_failure_determinants_findings_and_prognostic_implications_/10226825 %2 https://figshare.le.ac.uk/ndownloader/files/18448637 %K acute coronary syndrome %K coronary angiography %K decompensated heart failure %K outcomes %X 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. %I University of Leicester