Muhammad Rashid, Dmitry Abramov, Muhammad Usman Naseer, Harriette G C Van Spall, Fozia Z Ahmed, Claire Lawson, Mohamed Dafaalla, Evangelos Kontopantelis, Mohamed O Mohamed, Mark C Petrie, Mamas A Mamas
{"title":"现代经皮冠状动脉介入治疗时代心力衰竭住院合并首次急性心肌梗死的15年趋势、预测因素和结果","authors":"Muhammad Rashid, Dmitry Abramov, Muhammad Usman Naseer, Harriette G C Van Spall, Fozia Z Ahmed, Claire Lawson, Mohamed Dafaalla, Evangelos Kontopantelis, Mohamed O Mohamed, Mark C Petrie, Mamas A Mamas","doi":"10.1093/ehjopen/oeaf013","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Heart failure (HF) following acute myocardial infarction (AMI) is a global health concern, but data on risk factors associated with HF hospitalization post-AMI are limited.</p><p><strong>Methods and results: </strong>We analysed data from the Myocardial Ischaemia National Audit Project, including patients admitted with AMI from 1 January 2006 to 31 March 2019. Data linkage with Hospital Episode Statistics Admitted Patient Care and the Office for National Statistics facilitated a longitudinal analysis. High-risk patients were identified using dapagliflozin in patients without diabetes mellitus with acute myocardial infarction (DAPA-MI) and EMPAgliflozin on Hospitalization for Heart Failure and Mortality in Patients With aCuTe Myocardial Infarction (EMPACT-MI) criteria. We assessed clinical outcomes, adherence to European Society of Cardiology quality indicators, and predictors of HF-related hospitalizations. Out of 1 046 480 AMI patients, 9.1% overall, 17.2% in the DAPA-MI cohort, and 16.6% in the EMPACT-MI cohort experienced HF hospitalization within a year post-AMI. High-risk patients, defined by the presence of five risk factors, had nearly one in four hospitalizations with HF at 1-year follow-up. The predicted adjusted incidence rate for heart failure within 1 year almost doubled from 64.5 cases per 1000 person-years [95% confidence interval (CI): 51.1 to 78.0] in 2005, to 118.2 cases per 1000 person-years in 2019 (95% CI: 115.0 to 121.5). Heart failure hospitalization was associated with a three-fold increase in 1-year mortality (hazard ratio 3.01, 95% CI 2.95-3.13).</p><p><strong>Conclusion: </strong>One in 10 AMI patients experienced HF hospitalization within the first-year post-AMI, with rising trends in high-risk subgroups. These findings highlight the need for targeted post-AMI care strategies to improve outcomes and address the increasing burden of HF in the modern percutaneous coronary intervention era.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf013"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896973/pdf/","citationCount":"0","resultStr":"{\"title\":\"15-Year trends, predictors, and outcomes of heart failure hospitalization complicating first acute myocardial infarction in the modern percutaneous coronary intervention era.\",\"authors\":\"Muhammad Rashid, Dmitry Abramov, Muhammad Usman Naseer, Harriette G C Van Spall, Fozia Z Ahmed, Claire Lawson, Mohamed Dafaalla, Evangelos Kontopantelis, Mohamed O Mohamed, Mark C Petrie, Mamas A Mamas\",\"doi\":\"10.1093/ehjopen/oeaf013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>Heart failure (HF) following acute myocardial infarction (AMI) is a global health concern, but data on risk factors associated with HF hospitalization post-AMI are limited.</p><p><strong>Methods and results: </strong>We analysed data from the Myocardial Ischaemia National Audit Project, including patients admitted with AMI from 1 January 2006 to 31 March 2019. Data linkage with Hospital Episode Statistics Admitted Patient Care and the Office for National Statistics facilitated a longitudinal analysis. High-risk patients were identified using dapagliflozin in patients without diabetes mellitus with acute myocardial infarction (DAPA-MI) and EMPAgliflozin on Hospitalization for Heart Failure and Mortality in Patients With aCuTe Myocardial Infarction (EMPACT-MI) criteria. We assessed clinical outcomes, adherence to European Society of Cardiology quality indicators, and predictors of HF-related hospitalizations. Out of 1 046 480 AMI patients, 9.1% overall, 17.2% in the DAPA-MI cohort, and 16.6% in the EMPACT-MI cohort experienced HF hospitalization within a year post-AMI. High-risk patients, defined by the presence of five risk factors, had nearly one in four hospitalizations with HF at 1-year follow-up. The predicted adjusted incidence rate for heart failure within 1 year almost doubled from 64.5 cases per 1000 person-years [95% confidence interval (CI): 51.1 to 78.0] in 2005, to 118.2 cases per 1000 person-years in 2019 (95% CI: 115.0 to 121.5). Heart failure hospitalization was associated with a three-fold increase in 1-year mortality (hazard ratio 3.01, 95% CI 2.95-3.13).</p><p><strong>Conclusion: </strong>One in 10 AMI patients experienced HF hospitalization within the first-year post-AMI, with rising trends in high-risk subgroups. These findings highlight the need for targeted post-AMI care strategies to improve outcomes and address the increasing burden of HF in the modern percutaneous coronary intervention era.</p>\",\"PeriodicalId\":93995,\"journal\":{\"name\":\"European heart journal open\",\"volume\":\"5 2\",\"pages\":\"oeaf013\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-02-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896973/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European heart journal open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/ehjopen/oeaf013\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/3/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European heart journal open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ehjopen/oeaf013","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的：急性心肌梗死（AMI）后心力衰竭（HF）是一个全球性的健康问题，但AMI后HF住院相关危险因素的数据有限。方法和结果：我们分析了心肌缺血国家审计项目的数据，包括2006年1月1日至2019年3月31日住院的AMI患者。与住院病人护理统计数据和国家统计办公室的数据联系促进了纵向分析。在无糖尿病合并急性心肌梗死（DAPA-MI）患者中使用达格列净和emp格列净对急性心肌梗死患者心力衰竭住院和死亡率（empt - mi）标准进行了高危患者的鉴定。我们评估了临床结果、对欧洲心脏病学会质量指标的依从性以及hf相关住院的预测因素。在1046480例AMI患者中，总体9.1%，DAPA-MI组17.2%，EMPACT-MI组16.6%在AMI后一年内出现HF住院。高风险患者，定义为存在五种危险因素，在1年随访中，近四分之一的HF患者住院。一年内心力衰竭的预测调整发病率几乎翻了一番，从2005年的每1000人年64.5例[95%置信区间（CI）： 51.1至78.0]到2019年的每1000人年118.2例（95% CI: 115.0至121.5）。心力衰竭住院治疗与1年死亡率增加3倍相关（风险比3.01,95% CI 2.95-3.13）。结论：1 / 10的AMI患者在AMI后一年内出现HF住院，高危亚组呈上升趋势。这些发现强调需要有针对性的ami后护理策略来改善结果，并解决现代经皮冠状动脉介入治疗时代HF日益增加的负担。
15-Year trends, predictors, and outcomes of heart failure hospitalization complicating first acute myocardial infarction in the modern percutaneous coronary intervention era.
Aims: Heart failure (HF) following acute myocardial infarction (AMI) is a global health concern, but data on risk factors associated with HF hospitalization post-AMI are limited.
Methods and results: We analysed data from the Myocardial Ischaemia National Audit Project, including patients admitted with AMI from 1 January 2006 to 31 March 2019. Data linkage with Hospital Episode Statistics Admitted Patient Care and the Office for National Statistics facilitated a longitudinal analysis. High-risk patients were identified using dapagliflozin in patients without diabetes mellitus with acute myocardial infarction (DAPA-MI) and EMPAgliflozin on Hospitalization for Heart Failure and Mortality in Patients With aCuTe Myocardial Infarction (EMPACT-MI) criteria. We assessed clinical outcomes, adherence to European Society of Cardiology quality indicators, and predictors of HF-related hospitalizations. Out of 1 046 480 AMI patients, 9.1% overall, 17.2% in the DAPA-MI cohort, and 16.6% in the EMPACT-MI cohort experienced HF hospitalization within a year post-AMI. High-risk patients, defined by the presence of five risk factors, had nearly one in four hospitalizations with HF at 1-year follow-up. The predicted adjusted incidence rate for heart failure within 1 year almost doubled from 64.5 cases per 1000 person-years [95% confidence interval (CI): 51.1 to 78.0] in 2005, to 118.2 cases per 1000 person-years in 2019 (95% CI: 115.0 to 121.5). Heart failure hospitalization was associated with a three-fold increase in 1-year mortality (hazard ratio 3.01, 95% CI 2.95-3.13).
Conclusion: One in 10 AMI patients experienced HF hospitalization within the first-year post-AMI, with rising trends in high-risk subgroups. These findings highlight the need for targeted post-AMI care strategies to improve outcomes and address the increasing burden of HF in the modern percutaneous coronary intervention era.
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