ArticleCirculation. Heart failure2023
Long-Term Outcomes of Early Coronary Artery Disease Testing After New-Onset Heart Failure.
Article in Circulation. Heart failure, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 14 citations in OpenAlex.
- Patient-centered outcomes according to cancer status in cardiac surgery patients: a population-based cohort study.British journal of cancer · 2026Observational
- Testing for Coronary Artery Disease in Patients Newly Diagnosed with Heart Failure in Alberta, Canada.CJC open · 2026Article
- Identifying Demographic and Clinical Determinants of Ischemic Workup in Patients with Heart Failure.Journal of clinical medicine · 2024Article
- Article
- Association Between Coronary Assessment in Heart Failure and Clinical Outcomes Within a Safety-Net Setting Using a Target Trial Emulation Observational Design.Circulation. Cardiovascular quality and outcomes · 2024Observational
- Can Observational Data and Target Trial Emulation Inform Cardiovascular Disease Prevention and Management Guidelines?Circulation. Cardiovascular quality and outcomes · 2024Article
- Association Between Coronary Artery Disease Testing in Patients with New-Onset Heart Failure and Heart Failure Readmission and Mortality.Journal of general internal medicine · 2024Article
- Risk factors and prognosis of perioperative acute heart failure in elderly patients with hip fracture: case-control studies and cohort study.BMC musculoskeletal disorders · 2024Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundCoronary artery disease (CAD) testing remains underutilized in patients with newly diagnosed heart failure (HF). The longitudinal clinical impact of early CAD testing has not been well-characterized. We investigated changes in clinical management and long-term outcomes after early CAD evaluation in patients with incident HF.
methodsWe identified Medicare patients with incident HF from 2006 to 2018. The exposure variable was early CAD testing within 1 month of initial HF diagnosis. Covariate-adjusted rates of cardiovascular interventions after testing, including CAD-related management, were modeled using mixed-effects regression with clinician as a random intercept. We assessed mortality and hospitalization outcomes using landmark analyses with inverse probability-weighted Cox proportional hazards models. Falsification end points and mediation analysis were employed for bias assessment.
resultsAmong 309 559 patients with new-onset HF without prior CAD, 15.7% underwent early CAD testing. Patients who underwent prompt CAD evaluation had higher adjusted rates of subsequent antiplatelet/statin prescriptions and revascularization, guideline-directed therapy for HF, and stroke prophylaxis for atrial fibrillation/flutter than controls. In weighted Cox models, 1-month CAD testing was associated with significantly reduced all-cause mortality (hazard ratio, 0.93 [95% CI, 0.91-0.96]). Mediation analyses indicated that ≈70% of this association was explained by CAD management, largely from new statin prescriptions. Falsification end points (outpatient diagnoses of urinary tract infection and hospitalizations for hip/vertebral fracture) were nonsignificant.
conclusionsEarly CAD testing after incident HF was associated with a modest mortality benefit, driven mostly by subsequent statin therapy. Further investigation on clinician barriers to testing and treating high-risk patients may improve adherence to guideline-recommended cardiovascular interventions.
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