scholarly journals IMPEDANCE-GUIDED TREATMENT PREVENTS ACUTE HEART FAILURE IN THE COURSE OF ACUTE MYOCARDIAL INFARCTION AND REDUCED LONG-TERM MORTALITY

2010 ◽  
Vol 55 (10) ◽  
pp. A29.E277
Author(s):  
Michael Shochat ◽  
Avraham Shotan ◽  
David Blondhaim ◽  
Mark Kazatsker ◽  
Vladimir Gurovich ◽  
...  
2020 ◽  
Author(s):  
Zhaodong Guo ◽  
Guoli Sun ◽  
Feier Song ◽  
Li Lei ◽  
Yibo He ◽  
...  

Abstract Background Undefined adequate hydration may increase the risk of postoperative acute heart failure (AHF) while reducing the risk of contrast-induced acute kidney injury (CI-AKI) in patients with acute myocardial infarction (AMI). No relevant study exists regarding the association of postoperative AHF and long-term prognosis. This study is to evaluate the all-cause long-term mortality and establish a nomogram model for predicting postoperative AHF in this patient group. Methods In this prospective observational study, 1312 AMI patients undergoing coronary angiography (CAG) were included in the final analysis. Patients were assigned into a non-postoperative AHF-group (n=1235) or a postoperative AHF-group (n=77). The diagnosis of postoperative AHF was based on assessing symptom history, prior cardiovascular history, and potential cardiac and non-cardiac precipitants. Results The overall incidence of postoperative AHF was 77/1312 (5.9%). The incidence of all-cause long-term mortality was significantly higher in the postoperative AHF-group than in the non-postoperative AHF-group (50.6% vs. 17.0%, P<0.01). The median follow-up period was 7.0 years (interquartile range: 5.5 – 8.7). After adjusting for female, LVEF, eGFR, anemia, hypertension, diabetes mellitus, and PCI, postoperative AHF was the strongest predictor of all-cause long-term mortality (hazard ratio: 3.11; 95% CI: 1.83 – 5.30; P<0.01). A nomogram developed based on the four variables was with the AUC 0.83 on internal validation. Calibration curve showed that the predicted and actual probabilities of postoperative AHF were fitted well. Conclusions In patients with AMI undergoing CAG, postoperative AHF is the strongest predictor of all-cause long-term mortality. The nomogram showed an effective value of predicting postoperative AHF using preoperative predictions.


1999 ◽  
Vol 20 (16) ◽  
pp. 1158-1165 ◽  
Author(s):  
K.S. Spargias ◽  
S.J. Lindsay ◽  
G.I. Kawar ◽  
D.C. Greenwood ◽  
J.C. Cowan ◽  
...  

Heart ◽  
2021 ◽  
Vol 107 (5) ◽  
pp. 389-395
Author(s):  
Jianhua Wu ◽  
Alistair S Hall ◽  
Chris P Gale

AimsACE inhibition reduces mortality and morbidity in patients with heart failure after acute myocardial infarction (AMI). However, there are limited randomised data about the long-term survival benefits of ACE inhibition in this population.MethodsIn 1993, the Acute Infarction Ramipril Efficacy (AIRE) study randomly allocated patients with AMI and clinical heart failure to ramipril or placebo. The duration of masked trial therapy in the UK cohort (603 patients, mean age=64.7 years, 455 male patients) was 12.4 and 13.4 months for ramipril (n=302) and placebo (n=301), respectively. We estimated life expectancy and extensions of life (difference in median survival times) according to duration of follow-up (range 0–29.6 years).ResultsBy 9 April 2019, death from all causes occurred in 266 (88.4%) patients in placebo arm and 275 (91.1%) patients in ramipril arm. The extension of life between ramipril and placebo groups was 14.5 months (95% CI 13.2 to 15.8). Ramipril increased life expectancy more for patients with than without diabetes (life expectancy difference 32.1 vs 5.0 months), previous AMI (20.1 vs 4.9 months), previous heart failure (19.5 vs 4.9 months), hypertension (16.6 vs 8.3 months), angina (16.2 vs 5.0 months) and age >65 years (11.3 vs 5.7 months). Given potential treatment switching, the true absolute treatment effect could be underestimated by 28%.ConclusionFor patients with clinically defined heart failure following AMI, ramipril results in a sustained survival benefit, and is associated with an extension of life of up to 14.5 months for, on average, 13 months treatment duration.


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