A substantial number of patients develop new-onset heart failure (HF) within five years of being hospitalized for an acute myocardial infarction (AMI), according to new findings published in the American Journal of Cardiology.
“In those hospitalized with AMI, incidence of HF at the time of myocardial infarction varies from 14% to 36% and is associated with increased mortality,” wrote lead author Kamil F. Faridi, MD, MSc, a cardiologist at Yale School of Medicine, and colleagues. “However, risk of HF following hospital discharge for MI patients without preceding or concurrent HF is less well characterized.”
Faridi et al. explored the Cardiovascular Integrated Patient-level Analytical Platform database, focusing on information from more than 330,000 patients hospitalized for an AMI with no previous history of HF. All patients received care from April 2010 to March 2017. The mean patient age was 63.4. years old, and 65.9% were men.
Overall, the authors found, 8% of patients developed new-onset HF within one year of being discharged. After five years, that number increased to 18.8%. HF was diagnosed in the outpatient setting for 64.2% of those patients and during subsequent hospitalizations for all other patients.
Advanced chronic kidney disease (CKD) recurrent AMI and diabetes were all consistent predictors of HF after discharge.
“This adds to evidence showing that rates of HF hospitalization for patients with CKD in general are high, and that HF hospitalization is associated with greater risk of CKD progression,” Faridi and colleagues wrote. “One possible reason for increased risk of HF between CKD patients following MI may be progression of left ventricular diastolic dysfunction, which is prevalent in patients with CKD and associated with increased risk of HF and death.20 Diastolic dysfunction is also common after MI and associated with poor prognosis regardless of left ventricular ejection fraction and admission Killip Class.”
Black patients were also more likely to experience new-onset HF after discharge than any other patients, the authors added.
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Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.