Clinical predictors of heart failure in patients with first acute myocardial infarction

Ali, Abbas; Rybicki, Benjamin A.; Alam, Mohsin; Wulbrecht, Nancy; Richer-Cornish, Karen; Khaja, Fareed; Sabbah, Hani N.; Goldstein, Sidney

doi:10.1016/s0002-8703(99)70080-3

Cited by 90 publications

(50 citation statements)

References 17 publications

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“…Nonetheless, as expected, a stepwise increase in absolute risk was found for AHF across the ACS spectrum with unstable angina patients, with AHF patients having an in-hospital mortality of 6.7% and myocardial infarction patients with AHF without and with ST-segment elevation incurring a 10.3% and 16.5% in-hospital mortality, respectively. Furthermore, the GRACE investigators confirm previous reports 10 that AHF develops in a sizeable number (5.6%) of patients after admission regardless of biomarker elevation or ST-segment deviation and is perhaps deadlier (17.8% versus 12.0% across all ACS, PϽ0.0001).…”

Section: See P 494supporting

confidence: 84%

Acute Heart Failure Complicating Acute Coronary Syndromes

Velázquez

Pfeffer

2004

Circulation

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Section: See P 494supporting

confidence: 84%

Acute Heart Failure Complicating Acute Coronary Syndromes

Velázquez

Pfeffer

2004

Circulation

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“…Nevertheless, to the best of our knowledge there are no studies examining the relationship between CRP levels and LVD when both of these factors were assessed on admission. Concerning the issue of the association between CRP and LVD after AMI, it has been demonstrated that the presence of a larger enzymatic infarct size and angiographically multiple complex lesions, both of which reflect the severity of the ongoing disease process, are associated with both the occurrence of HF and/ or CS [31][32][33] and increased levels of CRP 30,33,34) during the early phase of AMI. Of interest, several other factors related to a pre-existing medical condition, such as diabetes, hypertension, previous coronary heart disease (CHD), and MVD at angiography have also been shown to be associated with the occurrence of HF or CS after AMI, [35][36][37] but none of these factors are associated with increased CRP levels in this clinical setting.…”

Section: Discussionmentioning

confidence: 99%

“…It has also been reported in one study that the amount of acute release of PAI-1 is significantly higher in AMI patients in Killip class ≥ 3 on admission than in those with a less severe presentation. 16) Concerning this last issue, among the factors associated with the occurrence of LVD after AMI, the presence of diabetes 45,46) and larger enzymatic infarct size 31,32) have also been shown to be associated with increased levels of PAI-1 in this setting. 10,13) Therefore, it is not possible to conclude that our finding of an association between higher PAI-1 levels and the occurrence of CS in AMI patients is merely due to a pre-existing medical condition or severity of the ongoing disease process.…”

Section: Discussionmentioning

confidence: 99%

Admission Levels of C-Reactive Protein and Plasminogen Activator Inhibitor-1 in Patients With Acute Myocardial Infarction With and Without Cardiogenic Shock or Heart Failure on Admission

et al. 2009

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SummaryScarce data exist on the relationship of C-reactive protein (CRP) or plasminogen activator inhibitor-1 (PAI-1) to the occurrence of heart failure (HF) or cardiogenic shock (CS) after acute myocardial infarction (AMI) and on the relationship between these biomarkers and mortality in CS patients. Thus, we compared high-sensitivity CRP and PAI-1 antigen plasma levels on admission among 3 age-and gender-matched AMI patients groups (consisting of 60 patients with CS, 60 with HF, and 60 without HF on admission), after determining that PAI-1 levels did not vary significantly diurnally in these groups by comparing the data among subgroups which were divided according to admission time within the groups. For CS patients, we also conducted regression analyses to examine the relations of these biomarkers to mortality. CRP levels both in CS (P < 0.001) and HF (P < 0.05) patients were significantly higher compared to those without HF, PAI-1 levels in CS patients were significantly higher compared to both those with (P < 0.05) and without HF (P < 0.01), and CRP and PAI-1 were independent predictors of in-hospital (Odds ratio [OR] = 6.12, 95% confidence intervals [95%CI] = 1.47-25.54 and OR = 5.92, 95%CI = 1.31-26.77, respectively) and 1-year mortality (OR = 5.53, 95%CI = 1.21-25.17 and OR = 5.48, 95%CI = 1.09-27.52, respectively) in CS patients. In conclusion, at admission, CRP is associated with the occurrence of CS and HF and PAI-1 is associated with the occurrence of CS after AMI, and they are of prognostic value in CS complicating AMI. (Int Heart J 2009; 50: 33-45)

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“…The CHF problem is magnified in individuals with diabetes, in whom incidence rates are two to five times greater than those in the general population (2)(3)(4)(5)(6)(7)(8). Nonetheless, heart failure has recently been termed "the frequent, forgotten, and often fatal complication of diabetes" (9), in part because estimates of the association between diabetes and CHF have been established primarily in studies that include diabetes as a potential risk factor in general populations (2,5,7,10).…”

mentioning

confidence: 99%

The Incidence of Congestive Heart Failure in Type 2 Diabetes

Nichols

Gullion²,

Koro³

et al. 2004

Diabetes Care

720

485

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OBJECTIVE -The aims of this study were to update previous estimates of the congestive heart failure (CHF) incidence rate in patients with type 2 diabetes, compare it with an age-and sex-matched nondiabetic group, and describe risk factors for developing CHF in diabetic patients over 6 years of follow-up.RESEARCH DESIGN AND METHODS -We performed a retrospective cohort study of 8,231 patients with type 2 diabetes and 8,845 nondiabetic patients of similar age and sex who did not have CHF as of 1 January 1997, following them for up to 72 months to estimate the CHF incidence rate. In the diabetic cohort, we constructed a Cox regression model to identify risk factors for CHF development.RESULTS -Patients with diabetes were much more likely to develop CHF than patients without diabetes (incidence rate 30.9 vs. 12.4 cases per 1,000 person-years, rate ratio 2.5, 95% CI 2.3-2.7). The difference in CHF development rates between persons with and without diabetes was much greater in younger age-groups. In addition to age and ischemic heart disease, poorer glycemic control (hazard ratio 1.32 per percentage point of HbA 1c ) and greater BMI (1.12 per 2.5 units of BMI) were important predictors of CHF development.CONCLUSIONS -The CHF incidence rate in type 2 diabetes may be much greater than previously believed. Our multivariate results emphasize the importance of controlling modifiable risk factors for CHF, namely hyperglycemia, elevated blood pressure, and obesity. Younger patients may benefit most from risk factor modification.

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Clinical predictors of heart failure in patients with first acute myocardial infarction

Cited by 90 publications

References 17 publications

Acute Heart Failure Complicating Acute Coronary Syndromes

Acute Heart Failure Complicating Acute Coronary Syndromes

Admission Levels of C-Reactive Protein and Plasminogen Activator Inhibitor-1 in Patients With Acute Myocardial Infarction With and Without Cardiogenic Shock or Heart Failure on Admission

The Incidence of Congestive Heart Failure in Type 2 Diabetes

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