Acute coronary syndrome (ACS) is frequently complicated by evidence of heart failure (HF). Those at highest risk for acute decompensated HF in the setting of ACS (ACS-HF) are older, female, and have preexisting heart disease, type 2 diabetes mellitus, hypertension, and/or kidney disease. The presence of ACS-HF is strongly associated with higher mortality and more frequent readmissions, especially for HF. Low implementation of guideline-directed medical therapy has further complicated the clinical care of this high-risk population. Improved utilization of current therapies, coupled with further investigation of strategies to manage ACS-HF, is desperately needed to improve outcomes in this vulnerable population, and the results of currently ongoing or recently concluded ACS-HF studies in this population are of great interest. In this review, we explore the pathophysiology, epidemiology, risk factors, and outcomes for patients with ACS-HF, and describe both existing evidence for management of this challenging condition and areas requiring further research.

急性冠状动脉综合征 (ACS) 经常因心力衰竭 (HF) 的证据而复杂化。在 ACS (ACS-HF) 情况下发生急性失代偿性 HF 的风险最高的人是年龄较大的女性，并且之前患有心脏病、2 型糖尿病、高血压和/或肾脏疾病。ACS-HF 的存在与更高的死亡率和更频繁的再入院密切相关，尤其是 HF。指南指导的药物治疗实施率低，使这一高危人群的临床护理更加复杂。迫切需要改进对当前疗法的利用，再加上对管理 ACS-HF 策略的进一步研究，以改善这一弱势人群的结果，目前正在进行或最近结束的 ACS-HF 研究在这一人群中的结果令人非常感兴趣。在这篇评论中，