Rate of admissions for heart failure following myocardial infraction dropping
The rate and risk of heart failure (HF) hospital admissions decrease with time following discharge for a first myocardial infarction (MI) event, according to a recent study.
Accessing the Myocardial Infarction Data Acquisition System of New Jersey, researchers retrospectively analysed admission and death data of 109,171 patients admitted for first AMI (mean age at first AMI admission, 63.3±14.4 years; 34.9 percent female). Generalized linear models were used to identify the risk of HF admission and all-cause following discharge.
One-year follow-up HF admission rates in 2015 was 1.40 percent, down 60 percent from the 3.48-percent admission rate in 2000. A similar trend was observed for 30-, 90- and 180-day HF admission rates (2000 vs 2015: 0.9 percent vs 0.67 percent, 1.9 percent vs 1.1 percent and 2.84 percent vs 1.3 percent, respectively).
The decline in HF admission rates was more pronounced at 5-year follow-ups: 7.21 percent in 2000 to 1.4 percent in 2015, an 80-percent decline.
Cox regression confirmed significantly decreasing risks of HF admissions over time (hazard ratio [HR], 0.955; 0.949–0.961).
Among the risk factors for the composite of death or HF admission were older age, female sex, a history of diabetes and hypertension, chronic obstructive pulmonary disease, and chronic kidney disease (p<0.001 for all).
In contrast, revascularization significantly decreased the risk of HF admissions following discharge for first MI (percutaneous coronary intervention: adjusted odds ratio [OR], 0.22; 0.19–0.25; p<0.001; coronary artery bypass graft: adjusted OR, 0.44; 0.38–0.51; p<0.001).