Hospital outcomes in patients presenting with congestive heart failure complicating acute myocardial infarction

Abstract

Patients with AMI presenting with CHF are at higher risk for adverse in-hospital outcomes. Despite this, they are less likely to be treated with reperfusion therapy and medications with proven mortality benefit.

Hospital protocols and evidence‐based therapies: The importance of integrating aldosterone blockade into the management of patients with post—acute myocardial infarction heart failure

“…1 The presence of HF in the patient post AMI greatly increases the risk for adverse clinical outcomes. The development of HF is associated with a significantly higher mortality during hospitalization for AMI, 2,3 at 30 days post AMI, 1 and at 6 months after discharge. 2 In addition, patients with HF have increased lengths of hospital stay for AMI by approximately 2 days and a greater readmission rate than patients without HF.…”

“…2 In addition, patients with HF have increased lengths of hospital stay for AMI by approximately 2 days and a greater readmission rate than patients without HF. [2][3][4] The high risk of mortality and morbidity in patients post AMI with HF mandates that eligible patients are treated early and maintained on each of the evidencebased, guideline-recommended therapies. One proven method that is increasingly employed in patients post AMI to accomplish this is the use of critical pathways.…”

“…[4][5][6] hospital stay than patients who did not present with HF. 3 Nearly 25% of eligible patients with HF did not receive aspirin and approximately 75% did not receive beta blockers or ACE inhibitors. 3 These findings hold true at the time of hospital release, with patients with HF much less frequently discharged on these evidence-based therapies than patients post AMI without HF (Fig.…”

Management of heart failure and left ventricular systolic dysfunction following acute myocardial infarction

“…1 These patients are commonly older, female, have a history of comorbidity (such as diabetes or hypertension), and have an anterior MI. 2,3 Several studies have evaluated outcomes in patients with a clinical diagnosis of mild to moderate HF (Killip class II and III) following an acute MI (AMI). These patients are at a higher risk for in-hospital mortality and adverse outcomes compared with those with no clinical signs of HF.…”

“…These patients are at a higher risk for in-hospital mortality and adverse outcomes compared with those with no clinical signs of HF. [1][2][3] This is true whether they present with HF at baseline or develop HF during hospitalization, and when HF symptoms are transient (present at baseline and resolve after admission). In this patient population, in-hospital mortality rates are estimated to be as high as 21%, 2, 3 with 1-year mortality rates of 40%.…”