Heart Failure Predictors in a Group of Patients with Myocardial Infarction

Sokol Myftiu1, Petrit Bara1, Ilir Sharka1

  • 1Service of Cardiology, University Hospital Centre "Mother Theresa", Tirana, Albania.

Insights

Heart failure (HF) is common after acute myocardial infarction (AMI), affecting 26.6% of patients. Key predictors include ejection fraction, age, and previous cardiovascular conditions.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Epidemiology

Background:

  • Heart failure (HF) is a significant complication following acute myocardial infarction (AMI).
  • Understanding the prevalence and predictors of HF post-AMI is crucial for patient management.

Purpose of the Study:

  • To determine the prevalence of HF in AMI patients at the University Hospital Centre of Tirana.
  • To identify demographic and clinical characteristics associated with HF in this population.
  • To pinpoint predictors of HF occurrence in patients with AMI.

Main Methods:

  • A retrospective study of 587 consecutive patients with AMI from 2013-2015.
  • Framingham criteria were used to diagnose HF upon admission.
  • Killip class ≥ 2 served as the primary in-hospital diagnostic criterion for HF.

Main Results:

  • HF was diagnosed in 156 patients (26.6%) during hospitalization.
  • Patients with HF differed significantly in age, sex, heart rate, blood pressure, prior AMI, glycemia, antihypertensive treatment, revascularization history, peripheral vascular disease, renal disease, ejection fraction, anemia, and atrial fibrillation.
  • Independent predictors for HF included ejection fraction, prior revascularization, peripheral vascular disease, age, sex, prior AMI, systolic blood pressure, and anemia.

Conclusions:

  • HF is a common complication post-AMI, with an increasing incidence despite evolving acute coronary syndrome epidemiology.
  • Mortality following AMI is decreasing, but HF incidence is rising.
  • High-risk subpopulations, including the elderly, those with prior coronary disease, and patients with comorbidities, require focused attention.
Abstract

Related Concept Videos

Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
520
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
1.1K
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
639
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
4.3K
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
459
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
611