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Temporal Trends in Post Myocardial Infarction Heart Failure and Outcomes among Older Adults.
Journal of Cardiac Failure 2021 September 12
OBJECTIVES: To determine national trends and long term outcomes of post myocardial infarction (MI) heart failure.
BACKGROUND: Myocardial infarction (MI) can be complicated by heart failure; there are limited data describing the contemporary patterns and clinical implications of post-MI heart failure.
METHODS: We studied MI patients aged ≥ 65 years from 2000-2013 in a Medicare database. New onset heart failure post-MI was defined as either heart failure during index MI admission or a hospitalization for heart failure within 1 year of index MI event. A trend analysis of the incidence of heart failure was performed, differences were examined by Gray tests. The 5-year mortality rates were evaluated and differences among heart failure cohorts were ascertained by Gray tests.
RESULTS: There were a total of 1,531,638 MI patients and 565,291 patients had heart failure (36.0%). The rate of heart failure during index admission was 32.3% and the frequency of heart failure hospitalization within 1 year was 10.4%. Patients with heart failure were older (81 vs 77 years). The temporal trend from 2001-2012 suggested a reduction in the incidence of heart failure during index admission (2001: 34.7%, 2012: 31.2%, p-trend < 0.01), as well as heart failure hospitalization within 1 year (2001: 11.3%, 2012: 8.7%, p-trend < 0.01). The 5-year mortality rate among patients without heart failure was 38.4% and for patients with any heart failure it was 68.7%.
CONCLUSION: Post-MI heart failure in older adults occurs in 1 in 3 patients within 1 year; heart failure portends significantly higher long-term mortality.
BACKGROUND: Myocardial infarction (MI) can be complicated by heart failure; there are limited data describing the contemporary patterns and clinical implications of post-MI heart failure.
METHODS: We studied MI patients aged ≥ 65 years from 2000-2013 in a Medicare database. New onset heart failure post-MI was defined as either heart failure during index MI admission or a hospitalization for heart failure within 1 year of index MI event. A trend analysis of the incidence of heart failure was performed, differences were examined by Gray tests. The 5-year mortality rates were evaluated and differences among heart failure cohorts were ascertained by Gray tests.
RESULTS: There were a total of 1,531,638 MI patients and 565,291 patients had heart failure (36.0%). The rate of heart failure during index admission was 32.3% and the frequency of heart failure hospitalization within 1 year was 10.4%. Patients with heart failure were older (81 vs 77 years). The temporal trend from 2001-2012 suggested a reduction in the incidence of heart failure during index admission (2001: 34.7%, 2012: 31.2%, p-trend < 0.01), as well as heart failure hospitalization within 1 year (2001: 11.3%, 2012: 8.7%, p-trend < 0.01). The 5-year mortality rate among patients without heart failure was 38.4% and for patients with any heart failure it was 68.7%.
CONCLUSION: Post-MI heart failure in older adults occurs in 1 in 3 patients within 1 year; heart failure portends significantly higher long-term mortality.
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