Acute heart failure with mildly reduced ejection fraction and myocardial infarction: a multi-institutional cohort study
Abstract Background Little research has been done on ischemic outcomes related to left ventricular ejection fraction (EF) in acute decompensated heart failure (ADHF). Methods A retrospective cohort study was conducted between 2001 and 2021 using the Chang Gung Research Database. ADHF Patients discha...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-023-03286-9 |
| _version_ | 1797818221027393536 |
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| author | Ming-Shyan Lin Po-Chang Wang Meng-Hung Lin Ting-Yu Kuo Yu-Sheng Lin Tien-Hsing Chen Ming-Horng Tsai Yao-Hsu Yang Chun-Liang Lin Chang-Min Chung Pao-Hsien Chu |
| author_facet | Ming-Shyan Lin Po-Chang Wang Meng-Hung Lin Ting-Yu Kuo Yu-Sheng Lin Tien-Hsing Chen Ming-Horng Tsai Yao-Hsu Yang Chun-Liang Lin Chang-Min Chung Pao-Hsien Chu |
| author_sort | Ming-Shyan Lin |
| collection | DOAJ |
| description | Abstract Background Little research has been done on ischemic outcomes related to left ventricular ejection fraction (EF) in acute decompensated heart failure (ADHF). Methods A retrospective cohort study was conducted between 2001 and 2021 using the Chang Gung Research Database. ADHF Patients discharged from hospitals between January 1, 2005, and December 31, 2019. Cardiovascular (CV) mortality and heart failure (HF) rehospitalization are the primary outcome components, along with all-cause mortality, acute myocardial infarction (AMI) and stroke. Results A total of 12,852 ADHF patients were identified, of whom 2,222 (17.3%) had HFmrEF, the mean (SD) age was 68.5 (14.6) years, and 1,327 (59.7%) were males. In comparison with HFrEF and HFpEF patients, HFmrEF patients had a significant phenotype comorbid with diabetes, dyslipidemia, and ischemic heart disease. Patients with HFmrEF were more likely to experience renal failure, dialysis, and replacement. Both HFmrEF and HFrEF had similar rates of cardioversion and coronary interventions. There was an intermediate clinical outcome between HFpEF and HFrEF, but HFmrEF had the highest rate of AMI (HFpEF, 9.3%; HFmrEF, 13.6%; HFrEF, 9.9%). The AMI rates in HFmrEF were higher than those in HFpEF (AHR, 1.15; 95% Confidence Interval, 0.99 to 1.32) but not in HFrEF (AHR, 0.99; 95% Confidence Interval, 0.87 to 1.13). Conclusion Acute decompression in patients with HFmrEF increases the risk of myocardial infarction. The relationship between HFmrEF and ischemic cardiomyopathy, as well as optimal anti-ischemic treatment, requires further research on a large scale. |
| first_indexed | 2024-03-13T09:04:56Z |
| format | Article |
| id | doaj.art-8fd3039c0c4b45d5a4b7ce916e5da17a |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-03-13T09:04:56Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-8fd3039c0c4b45d5a4b7ce916e5da17a2023-05-28T11:07:56ZengBMCBMC Cardiovascular Disorders1471-22612023-05-0123111110.1186/s12872-023-03286-9Acute heart failure with mildly reduced ejection fraction and myocardial infarction: a multi-institutional cohort studyMing-Shyan Lin0Po-Chang Wang1Meng-Hung Lin2Ting-Yu Kuo3Yu-Sheng Lin4Tien-Hsing Chen5Ming-Horng Tsai6Yao-Hsu Yang7Chun-Liang Lin8Chang-Min Chung9Pao-Hsien Chu10Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Chiayi BranchDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Chiayi BranchHealth Information and Epidemiology Laboratory, Chang Gung Memorial Hospital Chiayi BranchHealth Information and Epidemiology Laboratory, Chang Gung Memorial Hospital Chiayi BranchDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Chiayi BranchDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Chiayi BranchDepartment of Pediatrics, Chang Gung Memorial HospitalHealth Information and Epidemiology Laboratory, Chang Gung Memorial Hospital Chiayi BranchDepartment of Nephrology, Chang Gung Memorial Hospital Chiayi BranchDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Chiayi BranchDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou BranchAbstract Background Little research has been done on ischemic outcomes related to left ventricular ejection fraction (EF) in acute decompensated heart failure (ADHF). Methods A retrospective cohort study was conducted between 2001 and 2021 using the Chang Gung Research Database. ADHF Patients discharged from hospitals between January 1, 2005, and December 31, 2019. Cardiovascular (CV) mortality and heart failure (HF) rehospitalization are the primary outcome components, along with all-cause mortality, acute myocardial infarction (AMI) and stroke. Results A total of 12,852 ADHF patients were identified, of whom 2,222 (17.3%) had HFmrEF, the mean (SD) age was 68.5 (14.6) years, and 1,327 (59.7%) were males. In comparison with HFrEF and HFpEF patients, HFmrEF patients had a significant phenotype comorbid with diabetes, dyslipidemia, and ischemic heart disease. Patients with HFmrEF were more likely to experience renal failure, dialysis, and replacement. Both HFmrEF and HFrEF had similar rates of cardioversion and coronary interventions. There was an intermediate clinical outcome between HFpEF and HFrEF, but HFmrEF had the highest rate of AMI (HFpEF, 9.3%; HFmrEF, 13.6%; HFrEF, 9.9%). The AMI rates in HFmrEF were higher than those in HFpEF (AHR, 1.15; 95% Confidence Interval, 0.99 to 1.32) but not in HFrEF (AHR, 0.99; 95% Confidence Interval, 0.87 to 1.13). Conclusion Acute decompression in patients with HFmrEF increases the risk of myocardial infarction. The relationship between HFmrEF and ischemic cardiomyopathy, as well as optimal anti-ischemic treatment, requires further research on a large scale.https://doi.org/10.1186/s12872-023-03286-9Heart failure mildly reduced ejection fractionMyocardial infarctionMortality |
| spellingShingle | Ming-Shyan Lin Po-Chang Wang Meng-Hung Lin Ting-Yu Kuo Yu-Sheng Lin Tien-Hsing Chen Ming-Horng Tsai Yao-Hsu Yang Chun-Liang Lin Chang-Min Chung Pao-Hsien Chu Acute heart failure with mildly reduced ejection fraction and myocardial infarction: a multi-institutional cohort study BMC Cardiovascular Disorders Heart failure mildly reduced ejection fraction Myocardial infarction Mortality |
| title | Acute heart failure with mildly reduced ejection fraction and myocardial infarction: a multi-institutional cohort study |
| title_full | Acute heart failure with mildly reduced ejection fraction and myocardial infarction: a multi-institutional cohort study |
| title_fullStr | Acute heart failure with mildly reduced ejection fraction and myocardial infarction: a multi-institutional cohort study |
| title_full_unstemmed | Acute heart failure with mildly reduced ejection fraction and myocardial infarction: a multi-institutional cohort study |
| title_short | Acute heart failure with mildly reduced ejection fraction and myocardial infarction: a multi-institutional cohort study |
| title_sort | acute heart failure with mildly reduced ejection fraction and myocardial infarction a multi institutional cohort study |
| topic | Heart failure mildly reduced ejection fraction Myocardial infarction Mortality |
| url | https://doi.org/10.1186/s12872-023-03286-9 |
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