Risk Factors and Outcomes of Heart Failure Following First-Episode of Acute Myocardial Infarction-A Case Series Study of 161,384 Cases

Wen-Hwa Wang; Guang-Yuan Mar; Kai-Che Wei; Chin-Chang Cheng; Wei-Chun Huang

doi:10.3390/healthcare9101382

Risk Factors and Outcomes of Heart Failure Following First-Episode of Acute Myocardial Infarction-A Case Series Study of 161,384 Cases

Healthcare (Basel). 2021 Oct 16;9(10):1382. doi: 10.3390/healthcare9101382.

Authors

Wen-Hwa Wang^{1

2

3}, Guang-Yuan Mar^{1

4

5}, Kai-Che Wei^{6

7}, Chin-Chang Cheng^{1

4}, Wei-Chun Huang^{7

8

9}

Affiliations

¹ Department of Cardiology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
² College of Management, I-Shou University, Kaohsiung 824, Taiwan.
³ Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
⁴ Shu-Zen Junior College of Medicine and Management, Kaohsiung 821, Taiwan.
⁵ Superintendent, Kaohsiung Municipal United Hospital, Kaohsiung 804, Taiwan.
⁶ Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
⁷ School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan.
⁸ Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
⁹ Department of Physical Therapy, Fooyin University, Kaohsiung 831, Taiwan.

Abstract

Background: Heart failure (HF) is one of the important complications of acute myocardial infarction (AMI), but the epidemiology, associated risks and outcomes have not been well investigated in the era of broad use of fluoroscopy-guided angiographic intervention.

Methods: We analysed 161,384 subjects who had experienced the first episode of AMI during 1 January 2000 and 31 December 2012 using the Taiwan National Health Insurance Research Database.

Results: During the index AMI hospitalization, 23.6% of cases developed HF. Female, ≥65 years-old, non-ST-segment elevation type of MI, diabetes mellitus (DM), peripheral vascular occlusion disease (PAOD), chronic obstructive pulmonary disease (COPD), atrial fibrillation, and ventricular tachycardia/fibrillation (VT/VF) were associated with higher risks of developing HF. HF cases had inferior survival outcomes compared to non-HF cases in both the short and long term. Among those HF patients, ≥65 years, DM, PAOD, and VT/VF were associated with worse outcomes. On the contrary, coronary reperfusion intervention and treat-to-target pharmacologic treatment were associated with favourable survival outcomes.

Conclusions: HF remains common in the modern age and poses negative impacts in survival of AMI patients. It highlights that prudent prevention and early treatment of HF during AMI hospitalization is an important medical issue.

Keywords: National Health Insurance Research Database; heart failure; myocardial infarction; retrospective cohort study; risk factors; survival outcome.