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Temporal trends in the frequency and longer‐term outcome of heart failure complicating myocardial infarction
Author(s) -
Najafi Farid,
Dobson Annette J.,
Hobbs Michael,
Jamrozik Konrad
Publication year - 2007
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2007.05.014
Subject(s) - medicine , myocardial infarction , heart failure , incidence (geometry) , hazard ratio , odds ratio , diabetes mellitus , confidence interval , cardiology , cumulative incidence , heart disease , cohort , endocrinology , physics , optics
Aims: To investigate trends in incidence and long‐term outcome of heart failure (HF) developing within 28 days of first‐ever acute myocardial infarction (AMI). Methods and results: We identified all residents of Perth, Western Australia aged 25–64 years, with no history of HF, who experienced a non‐fatal, first‐ever AMI between 1984 and 1993, and followed them for ten years. All patients ( N =4006) met the criteria for ‘definite AMI’ in WHO MONItoring trends and determinants of CArdiovascular disease (MONICA) Project and 897 (22.4%) had early‐onset HF complicating the index event. After adjustment for age, current smoking, history of diabetes and hypertension, Q‐wave and anterior wall AMI, the odds of developing HF declined by 9% (odds ratio for period 1989–1993 relative to 1984–1988=0.91, 95% confidence interval (957percnt;CI): 0.78 to 1.06). Over 10 years of follow‐up, patients with early‐onset HF had a cumulative average number of re‐admissions of 28 per 100 as compared with 9 per 100 in patients without HF. After adjustment for age, history of diabetes and hypertension, the hazard of death in patients with early‐onset HF declined by 26% (HR for the period 1989–1993 relative to 1984–1988=0.74, 95%CI: 0.57 to 0.96). Conclusion: Our data suggest a decline in the incidence of, and show encouraging evidence of improvement in survival after, early‐onset HF complicating AMI.