Details

Autor(en) / Beteiligte

• Wang, Elizabeth Y
• Dixson, Jeffrey, MD
• Schiller, Nelson B., MD
• Whooley, Mary A., MD

Titel

Causes and Predictors of Death in Patients with Coronary Heart Disease (From the Heart and Soul Study)

Ist Teil von

• The American journal of cardiology, 2017-01, Vol.119 (1), p.27-34

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2017

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Abstract Although the prevalence of coronary heart disease (CHD) in the United States has increased during the past 25 years, cardiovascular mortality has declined due to advances in CHD therapy and prevention. We sought to determine the proportion of patients with CHD who die of cardiovascular versus non-cardiovascular causes and the causes and predictors of death, in a cohort of patients with CHD. The Heart and Soul Study enrolled 1024 participants with stable CHD between 2000-02 and followed them for 10 years. Causes of mortality were assigned based on detailed review of medical records, death certificates and coroner reports by blinded adjudicators. During 7680 person years of follow up, 401 participants died. Of these deaths, 42.4% were cardiovascular and 54.4% were non-cardiovascular. Myocardial infarction, stroke, and sudden death accounted for 72% of cardiovascular deaths. Cancer, pneumonia, and sepsis accounted for 67% of non-cardiovascular deaths. Independent predictors of cardiac mortality were older age, inducible ischemia on stress echocardiography, higher resting heart rate, smoking, lower hemoglobin, and higher N-terminal pro-brain natriuretic peptide (all p values <0.05); independent predictors of non-cardiac mortality included older age, inducible ischemia, higher heart rate, lower exercise capacity, and non-use of statins (all p values <0.05). In conclusion, mortality in this cohort was more frequently due to non-cardiovascular causes, and predictors of non-cardiovascular mortality included factors traditionally associated with cardiovascular mortality.