RT Journal Article
SR Electronic
T1 Heart failure following STEMI: a contemporary cohort study of incidence and prognostic factors
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e000551
DO 10.1136/openhrt-2016-000551
VO 4
IS 2
A1 Johannes M I H Gho
A1 Pieter G Postema
A1 Maartje Conijn
A1 Nienke Bruinsma
A1 Jonas S S G de Jong
A1 Connie R Bezzina
A1 Arthur A M Wilde
A1 Folkert W Asselbergs
YR 2017
UL http://openheart.bmj.com/content/4/2/e000551.abstract
AB Objective The aim of the current study was to determine the contemporary incidence, risk factors and prognosis of heart failure (HF) after ST-elevation myocardial infarction (STEMI).Methods We used the Arrhythmia Genetics in the Netherlands observational cohort study to identify patients with a first STEMI from 2001 onwards (n=1459). HF during follow-up was defined as hospitalisation for HF or an outpatient clinic visit for HF. Cox regression was performed to estimate the relationship between baseline covariates and the onset of HF.Results Follow-up was completed for 1360 (93.2%) patients with an overall median follow-up time of 6.7 years, 1232 (90.6%) of these patients had undergone primary percutaneous coronary intervention (PCI). A total of 85 patients (6.3%) developed HF during follow-up. HF cases were significantly older at their index MI (59.9 vs 57.2 years, P<0.001) and more commonly had a history of atrial fibrillation (6.1% vs 1.4%, P=0.001) than controls without HF. The crude incidence rate of HF after STEMI was 9.7 (95% CI 7.7 to 11.8) per 1000 person-years. In multivariable analysis, peak creatine kinase MB (CK-MB) levels (HR 1.11 per 100 U/L (95% CI 1.11 to 1.22)) and a left anterior descending artery (LAD) culprit lesion (HR 2.88 (95% CI 1.53 to 5.40)) were risk factors associated with HF.Conclusions We found a relatively low long-term contemporary incidence of HF after a first STEMI in the current PCI era in comparison with other reports. Higher CK-MB levels and a LAD culprit lesion at index STEMI were important risk factors for the development of HF after STEMI.Trial registration number NCT03007199; Results.