Heart Failure Incidence Following ST-Elevation Myocardial Infarction
Ricardo Costa1, Maria Trêpa1, Marta Oliveira1
1Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
The American Journal of Cardiology
|November 25, 2021
Summary
ST-elevation myocardial infarction (STEMI) survivors face a high risk of heart failure (HF). This study identified key predictors like age, diabetes, and reduced ejection fraction, highlighting HF
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Research
Background:
- ST-elevation myocardial infarction (STEMI) survivors have an elevated risk of developing heart failure (HF).
- The impact of primary percutaneous coronary intervention on this risk is not fully understood.
- Understanding HF incidence and predictors in contemporary STEMI patients is crucial for improved outcomes.
Purpose of the Study:
- To investigate the incidence of heart failure (HF) in patients surviving ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention.
- To identify independent predictors of incident HF and all-cause mortality in this cohort.
- To assess the association between HF development and mortality risk.
Main Methods:
- Retrospective analysis of 700 consecutive STEMI patients treated with primary percutaneous coronary intervention.
- Follow-up for a median of 43.6 months to ascertain HF events (hospitalization or outpatient management) and all-cause mortality.
- Statistical analysis using hazard ratios (HR) and 95% confidence intervals (CI) to determine independent predictors.
Main Results:
- Heart failure (HF) occurred in 15.7% of STEMI survivors during follow-up.
- Independent predictors for HF and all-cause mortality included older age, diabetes, longer door-to-balloon time, Killip-Kimball class ≥II, and left ventricular ejection fraction (LVEF) <50%.
- Heart failure (HF) independently increased the risk of all-cause mortality threefold (HR 3.52).
Conclusions:
- A significant proportion of contemporary STEMI patients develop heart failure (HF) post-primary percutaneous coronary intervention.
- Older age, diabetes, and reduced left ventricular ejection fraction (LVEF) <50% are critical predictors of HF and mortality.
- Heart failure (HF) significantly elevates mortality risk in STEMI survivors, underscoring the need for vigilant monitoring and management.
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