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Acute heart failure with mildly reduced ejection fraction and myocardial infarction: a multi-institutional cohort

Ming-Shyan Lin1,2,3, Po-Chang Wang1, Meng-Hung Lin4

  • 1Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan.

BMC Cardiovascular Disorders
|May 23, 2023
PubMed

Insights

Patients with heart failure with mid-range ejection fraction (HFmrEF) face higher risks of myocardial infarction. Further large-scale research is needed to understand HFmrEF and ischemic cardiomyopathy, guiding optimal anti-ischemic treatments.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Ischemic Outcomes

Background:

  • Limited research exists on ischemic outcomes in acute decompensated heart failure (ADHF) related to left ventricular ejection fraction (EF).
  • Understanding these outcomes is crucial for managing ADHF patients.

Purpose of the Study:

  • To investigate ischemic outcomes in patients with different ranges of left ventricular ejection fraction (EF) within acute decompensated heart failure (ADHF).
  • To compare the clinical outcomes, including cardiovascular mortality and rehospitalization, among patients with heart failure with preserved ejection fraction (HFpEF), mid-range ejection fraction (HFmrEF), and reduced ejection fraction (HFrEF).

Main Methods:

  • A retrospective cohort study utilizing the Chang Gung Research Database from 2001 to 2021.
  • Inclusion of ADHF patients discharged between January 1, 2005, and December 31, 2019.
  • Primary outcomes included cardiovascular mortality and heart failure rehospitalization, with secondary outcomes of all-cause mortality, acute myocardial infarction (AMI), and stroke.

Main Results:

  • A cohort of 12,852 ADHF patients was analyzed, with 2,222 (17.3%) classified as HFmrEF.
  • HFmrEF patients exhibited a higher prevalence of comorbidities like diabetes, dyslipidemia, and ischemic heart disease compared to HFrEF and HFpEF.
  • HFmrEF patients had the highest rate of AMI (13.6%) compared to HFpEF (9.3%) and HFrEF (9.9%), indicating an increased risk.

Conclusions:

  • Acute decompensation in HFmrEF patients is associated with an elevated risk of myocardial infarction.
  • Further large-scale research is warranted to explore the relationship between HFmrEF and ischemic cardiomyopathy.
  • Optimal anti-ischemic treatment strategies for HFmrEF require additional investigation.
Abstract

Keywords:
Heart failure mildly reduced ejection fractionMortalityMyocardial infarction

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