Heart Failure Incidence Following ST-Elevation Myocardial Infarction.

Autor: Costa R; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal. Electronic address: ricardofcosta91@gmail.com., Trêpa M; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal., Oliveira M; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal., Frias A; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal., Campinas A; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal., Luz A; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal., Santos M; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal., Torres S; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2022 Feb 01; Vol. 164, pp. 14-20. Date of Electronic Publication: 2021 Nov 21.
DOI: 10.1016/j.amjcard.2021.10.035
Abstrakt: ST-elevation myocardial infarction (STEMI) survivors have a heightened risk of developing heart failure (HF). The magnitude of this risk with the advent of primary percutaneous coronary intervention is less characterized. We aimed to examine the incidence and predictors of incident HF and all-cause mortality in a contemporary STEMI cohort. We performed a retrospective analysis of 700 consecutive patients with STEMI treated with primary percutaneous coronary intervention at a tertiary hospital. The primary outcome was the occurrence of HF during follow-up. HF was defined by HF hospitalization or the presence of congestion that led to de novo prescription or up-titration of diuretics in the outpatient clinic. The secondary outcome was defined by the occurrence of HF or all-cause mortality. During a median follow-up period of 43.6 months, HF events occurred in 110 patients (15.7%), 34 (4.8%) managed as outpatient and 76 (10.9%) requiring hospitalization. Left ventricular ejection fraction (LVEF) <50% was present in 76% of those who developed HF. Age (hazard ratio [HR] 1.03, 95% confidence interval [CI] 1.01 to 1.06), diabetes (HR 1.85, 95% CI 1.12 to 3.05), door-to-balloon time (HR 1.002, 95% CI 1.000 to 1.003), Killip-Kimball class ≥II (HR 2.24, 95% CI 1.32 to 3.80) and LVEF <50% (HR 1.71, 95% CI 1.01 to 2.92) were independent predictors. All-cause mortality incidence was 8.7%. HF was independently associated with a threefold increased risk of dying (HR 3.52, 95% CI 1.85 to 6.69, p <0.001). In conclusion, a substantial proportion of contemporary patients with STEMI develop HF, which triplicates the risk of dying. Older age, diabetes and LVEF <50% independently predicted the development of HF and all-cause death.
Competing Interests: Disclosures The authors have no conflicts of interest to declare.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: