Predominant subtype of heart failure after acute myocardial infarction is heart failure with non‐reduced ejection fraction

Abstract

Aims Patients who survive acute myocardial infarction (AMI) are at risk of being rehospitalized owing to the occurrence of acute decompensated heart failure (HF). However, the clinical characteristics of HF after AMI, especially the frequency of each HF subtype, are unclear. Methods and results We retrospectively studied 1055 patients with AMI. We excluded 257 patients, who were admitted >48 h after the onset of AMI, died during hospitalization or after discharge, and whose echocardiogram data at index hospitalization and follow-up data were missing. The remaining 798 patients (mean age: 66.5 ± 11.7 years) were investigated for a mean follow-up period of 4.9 years. All patients underwent emergency coronary angiography. The mean maximum creatine kinase levels were 2898 ± 2627 IU/L, and mean left ventricular ejection fraction (LVEF) was 58.9 ± 10.2%. Eighty-one patients (10.2%) were rehospitalized because of unexpected worsening of HF. Echocardiography data were available for 74 of the 81 patients during the acute phase of the second hospitalization, of which 30, 20, and 24 patients (41%, 27%, and 32%, respectively) were diagnosed as having HF with preserved LVEF (LVEF ≥ 50%), HF with mid-range LVEF (40% ≤ LVEF < 50%), and HF with reduced LVEF (LVEF < 40%), respectively. The ejection fraction during index hospitalization was 58.3 ± 9.7% in the HF with preserved LVEF group, 53.3 ± 10.2% in the HF with mid-range LVEF group, and 43.3 ± 10.5% in the HF with reduced LVEF group (P < 0.001). Conclusions The predominant subtypes of HF after AMI were HF with mid-range ejection fraction and preserved ejection fraction, or HF with non-reduced ejection fraction.

Serum Human Epididymis Protein 4 as a Prognostic Predictor of New-Onset Heart Failure among Women after Acute Coronary Syndrome: A Single-Center Retrospective Study

“…With the extension of life expectancy and the reduction in in-hospital mortality, nonfatal events after ACS strongly affect the patients' quality of life and significantly increase their mortality [21][22][23]. A recent study [24] showed that 1 out of 10 patients with ACS discharged from the hospital will suffer at least one readmission for HF within the first 5 years after ACS, which is much higher than the incidence of other complications, such as major bleeding [25,26] or stroke events [27].…”

Incident Heart Failure in Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

“…Currently, we also reported the frequency of the occurrence of HF subtypes after PCI, and HFpEF accounted for the largest proportion of newly diagnosed HF. Another study also indicated that the predominant subtypes of HF after AMI were HFmrEF and HFpEF, or HF with non-reduced EF ( 13 ). With the increase of population aging and the increased survival rate after MI, the prevalence of HF continues to rise, among which HFpEF has become the predominant type ( 16 ).…”

Cardiovascular outcomes with SGLT2 inhibitors versus DPP4 inhibitors and GLP-1 receptor agonists in patients with heart failure with reduced and preserved ejection fraction

“…In recent CVOTs that were initially conducted among patients with heart failure with reduced ejection fraction (HFrEF), and subsequently among patients with heart failure with preserved ejection fraction (HFpEF), SGLT2i reduced the incidence of HHF by approximately 30% and improved heart-failure specific endpoints such as Kansas City Cardiomyopathy Questionnaire scores and N-terminal pro b-type natriuretic peptide levels [7]. However, these trials did not assess MACE endpoints such as MI or stroke hospitalizations [8][9][10], which are major contributors to cardiovascular morbidity and mortality among HFrEF and HFpEF patients [11,12].…”