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Published on: April 17, 2021
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.
Aim:
The present study considers of the prevalence of heart failure (HF) in patients suffering from acute myocardial infarction (AMI) in the University Hospital Centre of Tirana (UHCT) "Mother Theresa"; the demographic and clinical characteristics of the sample during hospitalization; and the main predictors of heart failure occurrence inside the group of patients suffering an AMI.
Material And Methods:
During a period of study from 2013-2015 we studied demographic and clinical data from 587 consecutive patients presenting with AMI; Framingham criteria were adopted for classifying patients with HF upon admission.
Results:
A Killip class ≥ 2 was the main diagnostic criterion of HF during hospitalisation. HF was identified in 156 patients (26.6%). The subgroup with HF had significant differences when compared with the other patients with regard to age, sex (male), heart rate upon admission, systolic blood pressure on admission, previous episodes of AMI, glycemia on admission, previous antihypertensive treatment, previous revascularization procedures, peripheral vascular disease, chronic renal disease, ejection fraction (EF), anemia, and atrial fibrillation presence. Independent predictors for HF occurrence in the logistic regression model were EF, previous revascularization, peripheral vascular disease, age, sex, previous AMI, systolic blood pressure upon admission, and anaemia.
Conclusion:
As a conclusion, HF seems to be a common occurrence after AMI, in spite of changes in the epidemiological profile of the acute coronary syndrome. An increase in the incidence is registered as well, parallel to a decrease in the mortality following AMI. Attention must be shown for highly risked subpopulations, aged persons, patients with the previous coronary disease, and concomitant conditions.
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