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Patients with suspected acute myocardial infarction and acute heart failure: does it matter whether an infarction was
B W Karlson1, H Emanuelsson, J Herlitz
1Division of Cardiology, Sahlgrenska Hospital, Göteborg, Sweden.
Insights
Acute severe congestive heart failure symptoms can indicate acute myocardial infarction (AMI). Patients with AMI experienced higher 1-year mortality, highlighting its independent association with death.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Acute severe congestive heart failure necessitates ruling out acute myocardial infarction (AMI).
- Understanding the link between these conditions is crucial for prognosis.
Purpose of the Study:
- To characterize patients with acute severe congestive heart failure.
- To compare prognosis based on the presence or absence of AMI.
Main Methods:
- Prospective follow-up of 531 patients admitted for suspected AMI over 21 months.
- 1-year mortality and morbidity assessment.
- Analysis of baseline characteristics and risk factors.
Main Results:
- 40% of patients developed AMI within 3 days of admission.
- Patients with AMI had less prior history of congestive heart failure.
- 1-year mortality was 47% in the AMI group vs. 38% in the non-AMI group (p < 0.05).
- AMI, age, and diabetes were independent predictors of mortality.
Conclusions:
- Acute myocardial infarction is a significant cause of acute severe congestive heart failure.
- Development of AMI in this context is associated with poorer prognosis and increased mortality.
- Early identification and management are critical.
Abstract:
Symptoms of acute severe congestive heart failure always raise the suspicion of acute myocardial infarction (AMI). Our aim was to describe the characteristics and the prognosis among patients with acute severe congestive heart failure in relation to whether or not it was caused by AMI. Consecutive patients admitted to one single hospital during 21 months due to suspected AMI, who either had initial symptoms of acute severe congestive heart failure or developed such symptoms during the subsequent days, were prospectively followed for 1 year in terms of mortality and morbidity. Of 531 patients who fulfilled previously defined criteria for severe congestive heart failure, 40% developed AMI during the first 3 days in hospital. At baseline, these patients differed from the others, having a less frequent history of known congestive heart failure. Mortality during 1 year of follow-up was 47% among patients who developed AMI versus 38% among those who did not (p < 0.05). In addition to age and a history of diabetes, development of AMI was independently associated with death.