OBJECTIVES

The stable coronary artery disease (SCAD) has severe burden of disease and economic burden in China. The SCAD patients accompanying heart failure (HF) were advanced in worsening patients’ quality of life and consuming more scarce healthcare resources. This study aims to target the risk factors leading to HF among SCAD patients, in order to provide the evidence to facilitate the update of national SCAD clinical guideline in China.

METHODS

The retrospective observational study was processed using de-identified dataset derived from hospitals in Shannxi Province. The dataset covered diagnosed SCAD patients from 2013 to 2017, and were grouped into HF-free arm and HF-onsite arm, taking the advantage of propensity score matching (PSM) to ensure the similarity baseline characteristics between arms. Then the univariate and multivariate logistic regression models were recruited to identify the significant risk factors attributed to HF. In addition, the individual interviews were conducted with clinicians and epidemiologist to testify the confidence of quantitative analyses findings.

RESULTS

Out of 4063 patients, 2556 subjects were included after using PSM for age, gender, nationality, region, type of medical insurance. The equal-size subjects were assigned into HF-free and HF-onsite cohorts using 1:1 nearest neighbor matching. The logistic regression analysis showed that diabetes mellitus (OR=1.442, 95%CI: 1.077-1.930, P=0.014), atrial fibrillation (OR=2.555, 95%CI: 1.954-3.341, P<0.001) and chronic obstructive pulmonary diseases (OR=1.547, 95%CI: 1.214-1.970, P<0.001) were independent risk factors of SCAD patients in progressing to HF. The results of 6 individual interviews engaged with corresponding stakeholders were coincidence as quantitative findings.

CONCLUSIONS

Based on the both quantitative and qualitative results, the relative prevention and treatment actions should be considered in updating of national SCAD clinical guideline.