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| Name | Class |
|---|---|
| Moscow City Hospital named after A.K. Eramishantsev | OTHER_GOV |
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Acute heart failure (HF) is a common complication of acute coronary syndrome (ACS) associated with poor prognosis. Diagnosis of congestive HF in patients with initial, non-severe symptoms and signs may be challenging and early stages of this complication may be missed. To assess severity of HF in patients with ACS Killip classification is widely used but it does not take into account mild manifestations of HF. Thus, patients without rales in the lungs and/or S3 will be labelled as Killip class 1. The aim of this study is to determine the frequency, risk factors, abilities for early diagnosis using routine medical evaluation and clinical significance of subclinical and mildly symptomatic congestive HF in patients with ACS without persistent ST-segment elevation (NSTEACS).
The study will include 200 patients with NSTEACS without history of severe HF and overt signs of congestion at presentation. Presence and severity of dyspnea (according to Likert ans Visual analog scales), physical signs of heart failure (respiratory rate, distention of jugular veins, S3), peripheral oxygen saturation by pulse oximetry, heart rate and signs of ischemia on ECG, signs of congestion according to lung and vena cava inferior ultrasound and chest X-Ray/CT as well as levels of NT-proBNP, hsTn, CRP and FABP at presentation will be evaluated. Presence and severity of dyspnea, physical signs of heart failure, oxygen saturation, heart rate and signs of ischemia on ECG, lung and vena cava inferior ultrasound will be re-assessed after 6, 12 and 24 hours. During hospitalization occurrence or worsening of clinical HF. Clinical events will be followed up to 12 months after hospitalization.
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| Measure | Description | Time Frame |
|---|---|---|
| Worsening of HF from enrollment to 24 hours | Worsening of HF is stated if at least one of following is present
| from enrollment up to 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Changes severity of congestion according to lung and vena cava inferior ultrasound from enrollment to 24 hours after initial assessment at presentation | from enrollment up to 24 hours | |
| Composite of death, (re)myocardial infarction, stroke or hospitalisation for 12 months |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with ACS without persistent ST-segment elevation without history of severe HF and clinical signs of congestion at presentation
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation and City clinical hospital named after A. K. Eramishantsev, Moscow, Russia, 129327 | Moscow | 101990 | Russia |
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| ID | Term |
|---|---|
| D006333 | Heart Failure |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| up to 12 months |
| Composite of death, (re)infarction, stroke or worsening of HF from enrollment to discharge from the hospital | Worsening of HF is stated if at least one of following is present
| from admission to discharge or death during reference hospitalization, assessed up to 90 days |