G. Berton, F. Cavuto, H. Mahmoud, M. Mahmoud, R. Cordiano, R. Palmieri, F. Bagato, A. Cati

CONEGLIANO GENERAL HOSPITAL, CONEGLIANO; BASSANO DEL GRAPPA GENERAL HOSPITAL, BASSANO DEL GRAPPA; THE ABC HEART DISEASE FOUNDATION, CONEGLIANO, ITALY, CONEGLIANO; MINIA UNIVERSITY HOSPITAL, MINIA; ADRIA GENERAL HOSPITAL, ADRIA; ADRIA GENERAL HOSPITAL, ADRIA; FELTRE GENERAL HOSPITAL, FELTRE; CONEGLIANO GENERAL HOSPITAL, CONEGLIANO

Purpose: To assess the combined effect of heart failure and albuminuria on the long-term mortality risk after acute coronary syndrome (ACS) through 20 years of follow-up.

Methods: This study includes 589 patients with ACS enrolled in three centres and discharged alive. Baseline clinical and laboratory data were gathered within the first 7 days of hospitalization. Survival analysis was done to investigate the long term prognostic value of HF and albuminuria after ACS.

Results: During 20 years of follow-up, 437 (74.1%) patients died; they were sig- nificantly different for many clinical features from living patients. HF at presen- tation and albuminuria were more prevalent among dead patients (41% vs. 12% p<0.0001) and (26 % vs. 7% p< 0.0001) respectively. 3rd day albumin-creatinine ratio (ACR) values were also significantly higher among them (p<0.0001). Only 3 patients did not complete the follow-up and their time was censored before 20 years. Survival analysis showed that presence of either HF or albuminuria at ad- mission with ACS is independently associated with long term mortality. Moreover, patients who suffered from both pathologies were at higher mortality risk than patients with either.

Conclusions: The Presence of heart failure and albuminuria during ACS is inde- pendently associated with long-term mortality with an additive effect.

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