Abstract 15164: Characterizing the Incidence of Heart Failure Following Hospitalizations for Acute Myocardial Infarction
Introduction: The incidence of heart failure (HF) following acute myocardial infarction (AMI) in recent years is poorly characterized in the literature. We sought to estimate the long-term incidence of HF and the impact of percutaneous coronary intervention (PCI) on the risk of HF following AMI.
Methods: We performed a cohort study of adult patients hospitalized for AMI between 2006 and 2015, and with no prior history of HF using a large US real world database (Truven Health MarketScan® Database). All identified patients were required to have at least 183 days of enrollment prior to the AMI hospitalization and were followed up for a minimum of 1 year. Comparative analyses were conducted using binomial regression.
Results: A total of 264,631 patients hospitalized for AMI were identified during the study period. PCI was performed during AMI hospitalization among 48.6% of patients. Patients not administered PCI (no-PCI) were older (mean age 65.1 vs 60.2, p<0.001) and were more likely to be female (43.1% vs. 26.2%, p<0.001). Additionally, no-PCI patients had a higher frequency of comorbidities including hypertension, history of stroke and chronic kidney disease. The overall 1-year incidence of HF was 29.1% (95% confidence interval (CI): 28.9%, 29.3%). The incidence of HF was higher among no-PCI patients compared to PCI patients (35.1% vs. 22.7%, crude risk ratio (RR): 1.55, 95% CI: 1.53, 1.57). In multivariate analysis, after adjusting for demographics and comorbidities, the RR was attenuated but remained elevated (1.29, 95% CI: 1.28, 1.31).
Conclusions: In this analysis using a large real world database, HF was found to occur within 1 year following AMI among almost one-third of patients. Patients who were not administered PCI after AMI were at higher risk of developing incident HF compared with patients receiving PCI, even after accounting for baseline differences. However, even among patients who received PCI, HF incidence remained markedly high.
Author Disclosures: E. Nkhoma: Employment; Significant; Bristol-Myers Squibb. A. Ptaszynska: Employment; Significant; Bristol-Myers Squibb. A. Gomez: Employment; Significant; Bristol-Myers Squibb.
- © 2016 by American Heart Association, Inc.