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Inpatient management and outcomes of patients presenting with acute myocardial infarction (AMI) with a history of heart failure (HF) have not been well characterized. Hospitalizations for AMI from the Nationwide Inpatient Sample (2015–2018) were categorized according to a preexisting diagnosis of HF with preserved ejection fraction (HFpEF), reduced ejection fraction (HFrEF), or absence of HF. Utilization of invasive management and in-hospital outcomes were analyzed. Among 2,434,639 hospitalizations with an AMI, 19.8% had a history of HFrEF and 11.9% had a history of HFpEF. Coronary angiography and PCI respectively were performed significantly less among patients with HF (36.6% and 17.4% in HFpEF, 51.1% and 24.6% in HFrEF, and 64.4% and 42.3% among patients without HF, all  p  &lt; 0.0001). Mortality was more common among patients with HFrEF (10.3%) and HFpEF (8.3%) when compared to patients without a history of HF (6.4%),  p  &lt; 0.0001. HF is a common preexisting comorbidity among patients presenting with AMI and is associated with lower utilization of invasive procedures and higher complications including mortality, particularly among those with HFrEF.

expert review of cardiovascular therapy

Management and outcomes of acute myocardial infarction in patients with preexisting heart failure: an analysis of 2 million patients from the national inpatient sample