Heart Failure Hospitalization in Women with Signs and Symptoms of Ischemia: A Report from the Women’s Ischemia Syndrome Evaluation Study

• Published in: International journal of cardiology Vol. 223; pp. 936 - 939
• Main Authors: Bakir, May, Nelson, Michael D, Jones, Erika, Li, Quanlin, Wei, Janet, Sharif, Behzad, Minissian, Margo, Shufelt, Chrisandra, Sopko, George, Pepine, Carl J, Merz, C. Noel Bairey
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.11.2016
• Subjects: Aged; Cardiovascular; Coronary Angiography - methods; Coronary artery disease; Coronary Artery Disease - diagnosis; Coronary microvascular disease; Coronary Vessels - diagnostic imaging; Female; Follow-Up Studies; Heart failure; Heart Failure - diagnosis; Heart Failure - epidemiology; Heart Failure - physiopathology; Heart failure with preserved ejection fraction; Humans; Middle Aged; Myocardial Ischemia - diagnosis; Myocardial Ischemia - epidemiology; Myocardial Ischemia - physiopathology; Retrospective Studies; Risk Assessment - methods; Statistics as Topic; Stroke Volume; Symptom Assessment - methods; United States - epidemiology; Ventricular Function, Left; Women; Women; heart failure; EF; ejection fraction; Coronary Microvascular Disease; CAD; coronary arterial disease; HFpEF; Coronary Artery Disease; heart failure with preserved ejection fraction; coronary microvascular dysfunction; CMD; HF; Heart failure; Heart failure with preserved ejection fraction; Coronary artery disease; Coronary microvascular disease
• ISSN: 0167-5273; 1874-1754; 1874-1754
• DOI: 10.1016/j.ijcard.2016.07.301

Abstract Background Women with signs and symptoms of ischemia, no obstructive coronary artery disease, and preserved left ventricular ejection fraction enrolled in the National Heart Lung and Blood Institute (NHLBI) sponsored Women’s Ischemia Syndrome Evaluation (WISE) study have an unexpectedly high rate of subsequent heart failure (HF) hospitalization. We sought to verify and characterize the HF hospitalizations. Methods A retrospective chart review was preformed on 223 women with signs and symptoms of ischemia, undergoing coronary angiography for suspected coronary artery disease followed for 6 ± 2.6 years. Data were collected from a single site in the WISE study. Results At the time of study enrollment, the women were 57 ± 11 years of age, all had preserved left ventricular ejection fraction, and 81 (36%) had obstructive CAD (defined as > 50% stenosis in at least one epicardial artery). Among the 223 patients, 25 (11%) reported HF hospitalizations, of which 14/25 (56%) had recurrent HF hospitalizations ( > 2 hospitalizations). Medical records were available in 13/25 (52%) women. Left ventricular ejection fraction was measured in all verified cases, and was found to be preserved in 12/13 (92%). HF hospitalization was not related to obstructive CAD. Conclusion Among women with signs and symptoms of ischemia undergoing coronary angiography for suspected obstructive CAD, HF hospitalization at 6-year follow-up was predominantly characterized by a preserved ejection fraction, and not associated with obstructive CAD.