Knowledge of Illness Trajectory and Symptoms of Heart Failure in Patients with Acute Coronary Syndrome.

Background: Preventive management of heart failure (HF) should involve strategies to increase awareness of HF in patients with pre-HF and those at risk of HF. However, the perception of HF in patients with acute coronary syndrome (ACS) remains unclear. This study aimed to assess patient understanding of the definition of HF for the public (i.e., its illness trajectory [intermittent decline], impact on life expectancy [HF would limit life expectancy], and symptoms [shortness of breath, swelling]) that was introduced by the Japanese Circulation Society.

Methods: This cross-sectional questionnaire-based study enrolled 209 emergently admitted patients with ACS who underwent a cardiac rehabilitation program at a single university-based hospital. We identified the clinical characteristics of patients who understood HF definition.

Results: Among the enrolled patients (median age, 69 years; males, 81.3%; 59.8% with ST-elevation myocardial infarction), 64.0% and 53.1% chose the correct answers regarding HF illness trajectory and impact on life expectancy, respectively. While 92.3% of the patients correctly chose shortness of breath as a HF symptom, 56.7% correctly chose swelling. Patient understanding of the definition of HF was associated with younger age, but not with HF risk (i.e., hypertension, diabetes, higher natriuretic peptide levels, lower left ventricular ejection fraction) and history of symptomatic HF.

Conclusions: Among patients with ACS who participated in the cardiac rehabilitation program in this cohort, patient understanding of HF definition was suboptimal. Effective measures to improve their understanding should be considered to enhance the prevention of HF.