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Elderly patients hospitalized for MI are at elevated risk for developing subsequent HF
Despite improving in-hospital mortality rates, patients with no prior history of heart failure who are hospitalized with their first myocardial infarction are likely to develop heart failure, study results suggested.
Researchers from the University of Alberta, Edmonton in Alberta, Canada, enrolled 7,733 patients =65 years old who did not have a prior history of HF and who had their first MI between 1994 and 2000 into the study. The researchers followed the patients for up to five years. Of the 2,831 (36.7%) patients diagnosed with HF during the hospitalization for their index MI, an additional 3,040 patients who survived the index MI developed HF during the subsequent five years, bringing the total number of patient who developed HF during the five-year time period to 5,871 (75.9%). The five-year mortality rate for patients diagnosed with HF during the hospitalization period was higher than in patients who did not develop HF (39.1% vs. 26.7%; RR=1.8; 95% CI, 1.6-2.0).
The researchers reported a 28.1% (18.1% to 13.0%; P=.01) relative reduction in mortality between 1994 and 2000. There was also a 25.1% (31.4% to 39.3%; P=.001) increase in in-hospital HF among MI survivors during the same time period.
“In an elderly cohort of patients with their first MI, the in-hospital mortality improved over six years, but the incidence of in-hospital and subsequent HF increased.” the researchers wrote. “Subsequent HF is a very common after MI in the elderly, particularly in the first year, and confers a substantial risk for death.”
For more information:
- J Am Coll Cardiol. 2009;53:13-20.