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(Circulation. 2008;118:2019-2021.)
© 2008 American Heart Association, Inc.

Editorial

Heart Failure After Acute Myocardial Infarction

A Lost Battle in the War on Heart Failure?

Pardeep S. Jhund, BSc(Hons), MBChB, MSc; John J.V. McMurray, BSc(Hons), MBChB(Hons), MD

From the British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.

Correspondence to Prof John J.V. McMurray, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, G12 8TA, UK. E-mail j.mcmurray@bio.gla.ac.uk

Key Words: Editorials • heart failure • myocardial infarction • epidemiology

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Improvements in the treatment of acute myocardial infarction (AMI), especially use of reperfusion therapy, have led to larger numbers of survivors. In patients who would have survived despite reperfusion therapy, use of this treatment should lead to greater myocardial salvage and a reduced extent of ventricular injury in many. However, others who might not have survived previously may now do so, but with substantial left ventricular damage.^1,2 The net consequence of these 2 opposing effects on the early and later risk of developing heart failure after AMI is uncertain. There has been concern, however, that an increasing pool of survivors of AMI might fuel an "epidemic" of heart failure.

Article p 2057

Although we have a substantial amount of data on the rates of heart failure overall, rates of heart failure after AMI have been less well studied. Furthermore, the clinical trials, registries and epidemiological studies that have reported the rate of heart failure after AMI have used different case ascertainment and diagnostic criteria. Examination of 4 of the major trials of fibrinolysis (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries [GUSTO I], Global Use of Strategies to Open Occluded Coronary Arteries [GUSTO IIb and GUSTO III], and the Assessment of the Safety and Efficacy of a New Thrombolytic trial [ASSENT II]) in AMI revealed that heart failure was present at admission in 12.5% of the 61 041 participants, with 29.4% having evidence of heart failure at any time during admission.³ The rate was similar in . . . [Full Text of this Article]