Prognostic Impact of In‐Hospital and Postdischarge Heart Failure in Patients With Acute Myocardial Infarction: A Nationwide Analysis Using Data From the Cardiovascular Disease in Norway (CVDNOR) Project
Background Heart failure (HF) is a serious complication of acute myocardial infarction (AMI). We explored the excess mortality associated with HF as an early or late complication of AMI and describe changes over time in such excess mortality. Methods and Results All patients hospitalized with an inc...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2017-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.005277 |
| _version_ | 1811309900240781312 |
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| author | Gerhard Sulo Jannicke Igland Ottar Nygård Stein Emil Vollset Marta Ebbing Neil Poulter Grace M. Egeland Charlotte Cerqueira Torben Jørgensen Grethe S. Tell |
| author_facet | Gerhard Sulo Jannicke Igland Ottar Nygård Stein Emil Vollset Marta Ebbing Neil Poulter Grace M. Egeland Charlotte Cerqueira Torben Jørgensen Grethe S. Tell |
| author_sort | Gerhard Sulo |
| collection | DOAJ |
| description | Background Heart failure (HF) is a serious complication of acute myocardial infarction (AMI). We explored the excess mortality associated with HF as an early or late complication of AMI and describe changes over time in such excess mortality. Methods and Results All patients hospitalized with an incident AMI and without history of prior HF hospitalization were followed up to 1 year after AMI discharge for episodes of HF. New HF episodes were classified as in‐hospital HF if diagnosed during the AMI hospitalization or postdischarge HF if diagnosed within 1 year after discharge from the incident AMI. Logistic and Cox regression models were used to explore the excess mortality associated with HF categories. Changes over time in the excess mortality were assessed by testing the interaction between HF status and study year. In‐hospital HF increased in‐hospital mortality 1.79 times (odds ratio [OR], 1.79; 95% CI: 1.68–1.91). The excess mortality associated with HF increased by 4.3 times from 2001 to 2009 (P interaction<0.001) as a consequence of a greater decline of in‐hospital mortality among AMI patients without (9% per year) compared to those with in‐hospital HF (3% per year). Postdischarge HF increased all‐cause and CVD mortality 5.98 times (hazard ratio, 5.98; 95% CI: 5.39–6.64) and 7.93 times (subhazard ratio, 7.93; 95% CI: 6.84 –9.19), respectively. The relative excess 1‐year mortality associated with HF did not change significantly over time. Conclusions Development of HF—either as an early or late complication of AMI—has a negative impact on patients' survival. Changes in the excess mortality associated with HF are driven by modest improvements in survival among AMI patients with HF as compared to those without HF. |
| first_indexed | 2024-04-13T09:49:03Z |
| format | Article |
| id | doaj.art-fa75541b0ac34201af8f6d24413e809b |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T09:49:03Z |
| publishDate | 2017-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-fa75541b0ac34201af8f6d24413e809b2022-12-22T02:51:38ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-03-016310.1161/JAHA.116.005277Prognostic Impact of In‐Hospital and Postdischarge Heart Failure in Patients With Acute Myocardial Infarction: A Nationwide Analysis Using Data From the Cardiovascular Disease in Norway (CVDNOR) ProjectGerhard Sulo0Jannicke Igland1Ottar Nygård2Stein Emil Vollset3Marta Ebbing4Neil Poulter5Grace M. Egeland6Charlotte Cerqueira7Torben Jørgensen8Grethe S. Tell9Department of Global Public Health and Primary Care University of Bergen NorwayDepartment of Global Public Health and Primary Care University of Bergen NorwayDepartment of Clinical Science University of Bergen NorwayDepartment of Global Public Health and Primary Care University of Bergen NorwayDepartment of Global Public Health and Primary Care University of Bergen NorwayInternational Centre for Circulatory Health and Imperial Clinical Trials Unit National Heart and Lung Institute and School of Public Health Imperial College London United KingdomDepartment of Global Public Health and Primary Care University of Bergen NorwayResearch Centre for Prevention and Health, Capital Region Copenhagen DenmarkResearch Centre for Prevention and Health, Capital Region Copenhagen DenmarkDepartment of Global Public Health and Primary Care University of Bergen NorwayBackground Heart failure (HF) is a serious complication of acute myocardial infarction (AMI). We explored the excess mortality associated with HF as an early or late complication of AMI and describe changes over time in such excess mortality. Methods and Results All patients hospitalized with an incident AMI and without history of prior HF hospitalization were followed up to 1 year after AMI discharge for episodes of HF. New HF episodes were classified as in‐hospital HF if diagnosed during the AMI hospitalization or postdischarge HF if diagnosed within 1 year after discharge from the incident AMI. Logistic and Cox regression models were used to explore the excess mortality associated with HF categories. Changes over time in the excess mortality were assessed by testing the interaction between HF status and study year. In‐hospital HF increased in‐hospital mortality 1.79 times (odds ratio [OR], 1.79; 95% CI: 1.68–1.91). The excess mortality associated with HF increased by 4.3 times from 2001 to 2009 (P interaction<0.001) as a consequence of a greater decline of in‐hospital mortality among AMI patients without (9% per year) compared to those with in‐hospital HF (3% per year). Postdischarge HF increased all‐cause and CVD mortality 5.98 times (hazard ratio, 5.98; 95% CI: 5.39–6.64) and 7.93 times (subhazard ratio, 7.93; 95% CI: 6.84 –9.19), respectively. The relative excess 1‐year mortality associated with HF did not change significantly over time. Conclusions Development of HF—either as an early or late complication of AMI—has a negative impact on patients' survival. Changes in the excess mortality associated with HF are driven by modest improvements in survival among AMI patients with HF as compared to those without HF.https://www.ahajournals.org/doi/10.1161/JAHA.116.005277acute myocardial infarctionCVDNORheart failuremortalityNorwaytrends |
| spellingShingle | Gerhard Sulo Jannicke Igland Ottar Nygård Stein Emil Vollset Marta Ebbing Neil Poulter Grace M. Egeland Charlotte Cerqueira Torben Jørgensen Grethe S. Tell Prognostic Impact of In‐Hospital and Postdischarge Heart Failure in Patients With Acute Myocardial Infarction: A Nationwide Analysis Using Data From the Cardiovascular Disease in Norway (CVDNOR) Project Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acute myocardial infarction CVDNOR heart failure mortality Norway trends |
| title | Prognostic Impact of In‐Hospital and Postdischarge Heart Failure in Patients With Acute Myocardial Infarction: A Nationwide Analysis Using Data From the Cardiovascular Disease in Norway (CVDNOR) Project |
| title_full | Prognostic Impact of In‐Hospital and Postdischarge Heart Failure in Patients With Acute Myocardial Infarction: A Nationwide Analysis Using Data From the Cardiovascular Disease in Norway (CVDNOR) Project |
| title_fullStr | Prognostic Impact of In‐Hospital and Postdischarge Heart Failure in Patients With Acute Myocardial Infarction: A Nationwide Analysis Using Data From the Cardiovascular Disease in Norway (CVDNOR) Project |
| title_full_unstemmed | Prognostic Impact of In‐Hospital and Postdischarge Heart Failure in Patients With Acute Myocardial Infarction: A Nationwide Analysis Using Data From the Cardiovascular Disease in Norway (CVDNOR) Project |
| title_short | Prognostic Impact of In‐Hospital and Postdischarge Heart Failure in Patients With Acute Myocardial Infarction: A Nationwide Analysis Using Data From the Cardiovascular Disease in Norway (CVDNOR) Project |
| title_sort | prognostic impact of in hospital and postdischarge heart failure in patients with acute myocardial infarction a nationwide analysis using data from the cardiovascular disease in norway cvdnor project |
| topic | acute myocardial infarction CVDNOR heart failure mortality Norway trends |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.005277 |
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