Use of ejection fraction tests and coronary angiography in patients with heart failure

Christopher E. Kurtz, Yariv Gerber, Susan A. Weston, Margaret May Redfield, Steven J. Jacobsen, Veronique Lee Roger

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

OBJECTIVE: To examine the use of tests that measure ejection fraction (EF) and the use of coronary angiography among patients with an initial diagnosis of heart failure (HF). PATIENTS AND METHODS: All potential cases of incident HF in Olmsted County, Minnesota, between 1979 and 1999 were identified. In a random sample of cases validated with the Framingham criteria, we examined the frequency of tests that measure EF (echocardiography, radionuclide ventriculography, and left ventricular angiography) and coronary angiography within 90 days after diagnosis. RESULTS: A total of 655 patients with incident HF were included in the analysis. The use of tests that measure EF and coronary angiography increased early in the study period but stabilized thereafter. In the most recent years (1395-1999), EF was measured in 85% of the patients and coronary angiography performed in 12%. After adjustment for year of diagnosis, body mass index, hypertension, diabetes mellitus, smoking, hyperlipidemia, comorbidity, prior myocardial infarction, and prior angina, men were more likely than woman to have EF measured (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.01-2.16) and coronary angiography (OR, 2.61; 95% CI, 1.43-4.76). Increasing age was associated with less use of tests (OR, 0.03; 95% CI, 0.76-0.91; for EF measurement; OR, 0.72; 95% CI, 0.63-0.82; for coronary angiography for every 5-year increase in age). CONCLUSION: Among patients with HF, tests that measure EF are used substantially less than recommended, and coronary angiograms are used infrequently. Use was particularly low in women and elderly patients. Given the potential benefits of such tests, including more appropriate therapy and more objective monitoring of ventricular function, outcomes in persons with HF may be improved with more consistent use.

Original languageEnglish (US)
Pages (from-to)906-913
Number of pages8
JournalMayo Clinic Proceedings
Volume81
Issue number7
DOIs
StatePublished - 2006

Fingerprint

Coronary Angiography
Heart Failure
Odds Ratio
Confidence Intervals
Angiography
Radionuclide Ventriculography
Ventricular Function
Hyperlipidemias
Echocardiography
Comorbidity
Diabetes Mellitus
Body Mass Index
Smoking
Myocardial Infarction
Hypertension

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Use of ejection fraction tests and coronary angiography in patients with heart failure. / Kurtz, Christopher E.; Gerber, Yariv; Weston, Susan A.; Redfield, Margaret May; Jacobsen, Steven J.; Roger, Veronique Lee.

In: Mayo Clinic Proceedings, Vol. 81, No. 7, 2006, p. 906-913.

Research output: Contribution to journalArticle

Kurtz, Christopher E. ; Gerber, Yariv ; Weston, Susan A. ; Redfield, Margaret May ; Jacobsen, Steven J. ; Roger, Veronique Lee. / Use of ejection fraction tests and coronary angiography in patients with heart failure. In: Mayo Clinic Proceedings. 2006 ; Vol. 81, No. 7. pp. 906-913.
@article{cd161cf680eb4c5fa0ad8d20af96d022,
title = "Use of ejection fraction tests and coronary angiography in patients with heart failure",
abstract = "OBJECTIVE: To examine the use of tests that measure ejection fraction (EF) and the use of coronary angiography among patients with an initial diagnosis of heart failure (HF). PATIENTS AND METHODS: All potential cases of incident HF in Olmsted County, Minnesota, between 1979 and 1999 were identified. In a random sample of cases validated with the Framingham criteria, we examined the frequency of tests that measure EF (echocardiography, radionuclide ventriculography, and left ventricular angiography) and coronary angiography within 90 days after diagnosis. RESULTS: A total of 655 patients with incident HF were included in the analysis. The use of tests that measure EF and coronary angiography increased early in the study period but stabilized thereafter. In the most recent years (1395-1999), EF was measured in 85{\%} of the patients and coronary angiography performed in 12{\%}. After adjustment for year of diagnosis, body mass index, hypertension, diabetes mellitus, smoking, hyperlipidemia, comorbidity, prior myocardial infarction, and prior angina, men were more likely than woman to have EF measured (odds ratio [OR], 1.47; 95{\%} confidence interval [CI], 1.01-2.16) and coronary angiography (OR, 2.61; 95{\%} CI, 1.43-4.76). Increasing age was associated with less use of tests (OR, 0.03; 95{\%} CI, 0.76-0.91; for EF measurement; OR, 0.72; 95{\%} CI, 0.63-0.82; for coronary angiography for every 5-year increase in age). CONCLUSION: Among patients with HF, tests that measure EF are used substantially less than recommended, and coronary angiograms are used infrequently. Use was particularly low in women and elderly patients. Given the potential benefits of such tests, including more appropriate therapy and more objective monitoring of ventricular function, outcomes in persons with HF may be improved with more consistent use.",
author = "Kurtz, {Christopher E.} and Yariv Gerber and Weston, {Susan A.} and Redfield, {Margaret May} and Jacobsen, {Steven J.} and Roger, {Veronique Lee}",
year = "2006",
doi = "10.4065/81.7.906",
language = "English (US)",
volume = "81",
pages = "906--913",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "7",

}

TY - JOUR

T1 - Use of ejection fraction tests and coronary angiography in patients with heart failure

AU - Kurtz, Christopher E.

AU - Gerber, Yariv

AU - Weston, Susan A.

AU - Redfield, Margaret May

AU - Jacobsen, Steven J.

AU - Roger, Veronique Lee

PY - 2006

Y1 - 2006

N2 - OBJECTIVE: To examine the use of tests that measure ejection fraction (EF) and the use of coronary angiography among patients with an initial diagnosis of heart failure (HF). PATIENTS AND METHODS: All potential cases of incident HF in Olmsted County, Minnesota, between 1979 and 1999 were identified. In a random sample of cases validated with the Framingham criteria, we examined the frequency of tests that measure EF (echocardiography, radionuclide ventriculography, and left ventricular angiography) and coronary angiography within 90 days after diagnosis. RESULTS: A total of 655 patients with incident HF were included in the analysis. The use of tests that measure EF and coronary angiography increased early in the study period but stabilized thereafter. In the most recent years (1395-1999), EF was measured in 85% of the patients and coronary angiography performed in 12%. After adjustment for year of diagnosis, body mass index, hypertension, diabetes mellitus, smoking, hyperlipidemia, comorbidity, prior myocardial infarction, and prior angina, men were more likely than woman to have EF measured (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.01-2.16) and coronary angiography (OR, 2.61; 95% CI, 1.43-4.76). Increasing age was associated with less use of tests (OR, 0.03; 95% CI, 0.76-0.91; for EF measurement; OR, 0.72; 95% CI, 0.63-0.82; for coronary angiography for every 5-year increase in age). CONCLUSION: Among patients with HF, tests that measure EF are used substantially less than recommended, and coronary angiograms are used infrequently. Use was particularly low in women and elderly patients. Given the potential benefits of such tests, including more appropriate therapy and more objective monitoring of ventricular function, outcomes in persons with HF may be improved with more consistent use.

AB - OBJECTIVE: To examine the use of tests that measure ejection fraction (EF) and the use of coronary angiography among patients with an initial diagnosis of heart failure (HF). PATIENTS AND METHODS: All potential cases of incident HF in Olmsted County, Minnesota, between 1979 and 1999 were identified. In a random sample of cases validated with the Framingham criteria, we examined the frequency of tests that measure EF (echocardiography, radionuclide ventriculography, and left ventricular angiography) and coronary angiography within 90 days after diagnosis. RESULTS: A total of 655 patients with incident HF were included in the analysis. The use of tests that measure EF and coronary angiography increased early in the study period but stabilized thereafter. In the most recent years (1395-1999), EF was measured in 85% of the patients and coronary angiography performed in 12%. After adjustment for year of diagnosis, body mass index, hypertension, diabetes mellitus, smoking, hyperlipidemia, comorbidity, prior myocardial infarction, and prior angina, men were more likely than woman to have EF measured (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.01-2.16) and coronary angiography (OR, 2.61; 95% CI, 1.43-4.76). Increasing age was associated with less use of tests (OR, 0.03; 95% CI, 0.76-0.91; for EF measurement; OR, 0.72; 95% CI, 0.63-0.82; for coronary angiography for every 5-year increase in age). CONCLUSION: Among patients with HF, tests that measure EF are used substantially less than recommended, and coronary angiograms are used infrequently. Use was particularly low in women and elderly patients. Given the potential benefits of such tests, including more appropriate therapy and more objective monitoring of ventricular function, outcomes in persons with HF may be improved with more consistent use.

UR - http://www.scopus.com/inward/record.url?scp=33745608215&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745608215&partnerID=8YFLogxK

U2 - 10.4065/81.7.906

DO - 10.4065/81.7.906

M3 - Article

C2 - 16835970

AN - SCOPUS:33745608215

VL - 81

SP - 906

EP - 913

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 7

ER -