Abstract 11133: The Incidence and Predicting Factors of Heart Failure After First Acute Myocardial Infarction: A Population[[Unable to Display Character: ‐]]Based Study in Taiwan

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Cheng-Han Lee ◽  
Yi-Heng Li ◽  
Ching-Lan Cheng ◽  
Jyh-Hong Chen ◽  
Yea-Huei Kao Yang
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Coronary Revascularization ◽  
Temporal Trends ◽  
Population Based ◽  
Research Database ◽  
Index Hospitalization ◽  
Predicting Factors ◽  
One Year

Background: Early coronary revascularization and medical therapy advancement improve the survival of patients (pts) with acute myocardial infarction (AMI). However, survivors of AMI are at heightened risk of developing heart failure (HF) and there is a paucity of information regarding this issue in Asian countries. This study described the temporal trends in the incidence of HF after the first AMI and the predicting factors of HF development in Taiwan. Methods: We conducted a nationwide population-based cohort study by using 1999 to 2009 National Health Insurance Research Database. Pts aged≧18 years, with no history of HF, who hospitalized with a first AMI between January 2002 and December 2008 were identified and followed up for one year. The primary outcome was HF. We evaluated the incidence of HF during the index hospitalization, 30 days, 6 months, and one year after the discharge. The predicting factors of HF were identified by Cox proportional hazard model. Results: Overall, 42,011 first AMI pts (mean age 64.4 ± 13.8 years; male 75.0%) from 2002 to 2008 were identified. The HF incidence during the index hospitalization was 14.8%. After exclusion of HF during the hospitalization, the overall HF prevalence at 30 days, 6 months, and 1 year was 9.6%, 14.2%, and 16.8%, respectively. The HF prevalence at 1 year declined from 17.9% to 14.9% (p<0.05) from 2002 to 2008. The independent predicting factors of HF after the first AMI were elder age (≧65 years) (adjusted HR 1.81, 95% CI 1.51-2.18), diabetes mellitus (adjusted HR 1.30, 95% CI 1.21-1.41), chronic kidney disease (adjusted HR 1.41, 95% CI 1.20-1.65), use of loop diuretics within 30 days after the discharge (adjusted HR 2.21, 95% CI 2.00-2.43), and recurrent AMI (adjusted HR 2.43, 2.16-2.74). Conclusions: Survivors of AMI without prior HF remain at risk of developing HF in Taiwan and most episodes occur within 6 months after AMI. Five important clinical factors of HF were identified that may help us for risk stratification.

scholarly journals Trends in mortality, co-morbidity and treatment after acute myocardial infarction in patients with rheumatoid arthritis 1998–2013

2020 ◽  
Vol 9 (8) ◽  
pp. 931-938 ◽  
Author(s):  
Mattias Skielta ◽  
Lars Söderström ◽  
Solbritt Rantapää-Dahlqvist ◽  
Solveig W Jonsson ◽  
Thomas Mooe
Keyword(s):  
Rheumatoid Arthritis ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Congestive Heart Failure ◽  
Cox Regression Analysis ◽  
Co Morbidity ◽  
One Year ◽  
Over Time

Aims: Rheumatoid arthritis may influence the outcome after an acute myocardial infarction. We aimed to compare trends in one-year mortality, co-morbidities and treatments after a first acute myocardial infarction in patients with rheumatoid arthritis versus non-rheumatoid arthritis patients during 1998–2013. Furthermore, we wanted to identify characteristics associated with mortality. Methods and results: Data for 245,377 patients with a first acute myocardial infarction were drawn from the Swedish Register of Information and Knowledge about Swedish Heart Intensive Care Admissions for 1998–2013. In total, 4268 patients were diagnosed with rheumatoid arthritis. Kaplan-Meier analysis was used to study mortality trends over time and multivariable Cox regression analysis was used to identify variables associated with mortality. The one-year mortality in rheumatoid arthritis patients was initially lower compared to non-rheumatoid arthritis patients (14.7% versus 19.7%) but thereafter increased above that in non-rheumatoid arthritis patients (17.1% versus 13.5%). In rheumatoid arthritis patients the mean age at admission and the prevalence of atrial fibrillation increased over time. Congestive heart failure decreased more in non-rheumatoid arthritis than in rheumatoid arthritis patients. Congestive heart failure, atrial fibrillation, kidney failure, rheumatoid arthritis, prior diabetes mellitus and hypertension were associated with significantly higher one-year mortality during the study period 1998–2013. Conclusions: The decrease in one-year mortality after acute myocardial infarction in non-rheumatoid arthritis patients was not applicable to rheumatoid arthritis patients. This could partly be explained by an increased age at acute myocardial infarction onset and unfavourable trends with increased atrial fibrillation and congestive heart failure in rheumatoid arthritis. Rheumatoid arthritis per se was associated with a significantly worse prognosis.

scholarly journals Incidence, Temporal Trends, and Prognostic Impact of Heart Failure Complicating Acute Myocardial Infarction

2015 ◽  
Vol 3 (3) ◽  
pp. 234-242 ◽  
Author(s):  
Liyew Desta ◽  
Tomas Jernberg ◽  
Ida Löfman ◽  
Claes Hofman-Bang ◽  
Inger Hagerman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Temporal Trends ◽  
Prognostic Impact

Abstract 148: The Timing of 30-Day Readmissions after Hospitalization for Heart Failure and Acute Myocardial Infarction

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Kumar Dharmarajan ◽  
Fu-Chi Hsieh ◽  
Zhenqiu Lin ◽  
Joseph S Ross ◽  
Nancy Kim ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Coronary Revascularization ◽  
Hospital Readmissions ◽  
Cumulative Number ◽  
Readmission Rates ◽  
Time Period ◽  
Equal Rate ◽  
Readmission Risk

Background: Readmissions are frequent and costly outcomes in patients hospitalized for heart failure (HF) and acute myocardial infarction (AMI). Knowledge of the exact timing of 30-day readmissions after hospitalization for HF and AMI can help identify time periods during which patients are at the highest readmission risk and guide the development of interventions designed to prevent early readmissions. Methods: Using Medicare Standard Analytic and Denominator files, we identified all HF and AMI hospitalizations in 2007-2009. We excluded hospitalizations for patients aged<65, transferred out, discharged against medical advice, or with an inpatient death. For both HF and AMI cohorts, we identified all readmissions to short-stay acute care hospitals due to any cause occurring within 30 days of hospital discharge except for planned coronary revascularization. Our primary outcome was the number of observed readmissions occurring during each day (0-30) after discharge. We also calculated the cumulative number of observed readmissions occurring during the 1 st 3 days, 1 st week, and 1 st 15 days after discharge. We used a one-tailed two-proportion z test to evaluate if the proportion of readmissions during the 1 st 3 days, 1 st week, and 1 st 15 days was higher than what would be expected had readmissions occurred at an equal rate during the 30 days (alpha=0.05). Results: We identified 329,308 readmissions within 30 days after 1,330,157 hospitalizations for HF (4,633 hospitals) and 108,992 readmissions within 30 days after 548,834 hospitalizations for AMI (3,895 hospitals). Readmission frequency by day is described for both HF and AMI in the accompanying figure. Following hospitalization for HF, 13.4% of 30-day readmissions occur during the 1 st 3 days after discharge, 31.7% occur during the 1 st week, and 61.0% occur during the 1 st 15 days. Following hospitalization for AMI, 19.1% of 30-day readmissions occur during the 1 st 3 days after discharge, 40.1% occur during the 1 st week, and 67.6% occur during the 1 st 15 days. For both HF and AMI cohorts, readmissions after 3, 7, and 15 days were higher than what would be predicted had readmission rates remained constant (p<0.0001 for all). Conclusion: For patients hospitalized with HF and AMI, a disproportionately high percentage of 30-day readmissions occur soon after discharge. Interventions designed to reduce hospital readmissions may therefore generate substantive benefits when applied to the time period shortly after hospitalization.

Abstract 223: National and Regional Trends in Hospitalizations for Hemorrhagic Stroke after Acute Myocardial Infarction in the United States: 1999-2010

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Ruizhi Shi ◽  
Yun Wang ◽  
Judith H Lichtman ◽  
Kumar Dharmarajan ◽  
Frederick A Masoudi ◽  
...  
Keyword(s):  
United States ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hemorrhagic Stroke ◽  
Temporal Trends ◽  
The United States ◽  
Mortality Rates ◽  
Hospitalization Rates ◽  
One Year ◽  
Stroke Belt

Background: Elderly survivors of acute myocardial infarction (AMI) are at elevated risk for hemorrhagic stroke, which has a mortality rate of approximately 50%. Increasing use of warfarin for arterial fibrillation and anti-platelet agents for AMI combined with an increasing aging population may have influenced the risk of post-AMI strokes. We sought to characterize temporal trends in the risk for and mortality from hemorrhagic stroke over 12 years among older AMI survivors of different age, sex, race, revascularization status, and region within the US. Methods: We used 100% of Medicare inpatient claims data to identify all fee-for-service (FFS) patients aged> 64 years who were hospitalized for AMI in 1999-2010. We excluded patients who died during the hospitalization or were transferred. Revascularization procedures were identified during the index admission. We used a Cox proportional-hazards regression model to estimate the risk-adjusted annual changes in one-year hemorrhagic stroke hospitalization after AMI, overall and by subgroups. Changes were adjusted by age, gender, race, medical history and comorbidities. We calculated the 30-day mortality among patients readmitted for hemorrhagic stroke. Stroke belt regions were defined as the states with high stroke hospitalization rates in the southeast United States. Results: Among 2,433,036 AMI hospitalizations and 4,852 hemorrhagic stroke readmissions, the risk-adjusted one-year post-AMI hemorrhagic stroke rate remained stable from 1999 to 2010 (range, 0.2% to 0.3%). No significant trends were found for post-AMI stroke rates across all age-sex-race groups and all treatment groups (Figure). Thirty-day mortality rates for stroke after AMI did not show significant changes (1999, 46.7%, 95% CI 39.9%-53.7%; 2010, 50.7%, 95% CI 45.3%-56.1%; range: 46.5% to 54.6%). No difference was found in post-AMI hemorrhagic stroke rates between the stroke belt and non-stroke belt regions. Conclusions: From 1999 to 2010, the overall hospitalization rates of hemorrhagic stroke after AMI were relatively stable without significant changes across all subgroups. Thirty-day mortality rates remained largely unchanged over time. Stroke risk in the stroke belt was not found significantly higher comparing with non-stroke belt states.

Abstract 16438: Combined Prognostic Significance of Heart Failure and Chronic Kidney D in Patients With Acute Myocardial Infarction. The Fast-mi Programme

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nicolas Danchin ◽  
Guillaume Cayla ◽  
Yves Cottin ◽  
Pierre COSTE ◽  
Franck ALBERT ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Acute Stage ◽  
Prior History ◽  
First Year ◽  
History Of ◽  
One Year

Introduction: We assessed the interplay and potential cumulative effects of heart failure (HF) and chronic kidney disease (CKD) on one-year and 5-year outcomes in patients admitted for acute myocardial infarction (AMI). Methods: FAST-MI consists of 3 nationwide French surveys 5 years apart from 2005 to 2015, consecutively including STEMI and NSTEMI patients over 1-month periods. Using Cox regression, we analysed the association between CKD and non-fatal HF and death during the first year after discharge according to absence of HF, previous HF and acute stage HF. In those alive at 1 year, we also analysed the prognostic significance of admission for non-fatal HF after AMI and CKD on 5-year mortality. Results: Of 12,301 patients discharged alive, 7960 (64.7%) had normal renal function and no HF. Both CKD and type of HF were independent predictors of one-year death: one-year mortality was 3.6%, 14.3% and 24.5% in patients with no HF, acute stage HF, and prior history of HF, respectively. Within each group, mortality increased by increasing degree of CKD. In patients with no history of HF, CKD was a strong independent correlate of hospital admission for HF within one year of discharge: HR (95%CI) 1.33 (1.01-1.74), P=0.04 for CKD-EPI 30-60, and 1.76 (1.16-2.67), P=0.008 for CKD-EPI <30, as was the case in patients with HF at the acute stage (Figure). Finally, in patients alive at 1year, both HF admission during the first year (adjusted HR 1.85, 1.42-2.39, P<0.001) and CKD (HR 1,23, 1.04-1.47, P=0.02 and HR 1.86, 1.41-2.44, P<0.001, respectively for moderate and severe renal dysfunction), were independent predictors of 5-year death. Conclusion: After AMI, CKD and HF are major independent prognostic factors for death and/or subsequent HF admission. Both are likely to be important therapeutic targets to improve long-term outcomes after AMI.

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