Trends in the risk of early and late-onset heart failure as an adverse outcome of acute myocardial infarction: A Cardiovascular Disease in Norway project

TY - JOUR

T1 - Trends in the risk of early and late-onset heart failure as an adverse outcome of acute myocardial infarction

T2 - A Cardiovascular Disease in Norway project

AU - Sulo, Gerhard

AU - Igland, Jannicke

AU - Nygård, Ottar

AU - Vollset, Stein E.

AU - Ebbing, Marta

AU - Cerqueira, Charlotte

AU - Egeland, Grace M.

AU - Jørgensen, Torben

AU - Tell, Grethe S.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Aims: Heart failure is a serious complication of acute myocardial infarction, leading to a poor prognosis. We explored trends in the risk of heart failure among patients hospitalised with an incident acute myocardial infarction in Norway during 2001-2009. Methods and results: A total of 69,372 patients were followed for an episode of heart failure occurring either during (early-onset heart failure) or within one year of discharge from the incident acute myocardial infarction hospitalisation (late-onset heart failure). Logistic regression and competing risk regression models were used to explore trends in early and late-onset heart failure respectively. Overall, 17.1% of patients had early-onset heart failure. The odds of heart failure increased by 2.3% per year (odds ratio = 1.023; 95% confidence interval: 1.015-1.031), influenced by an increase of 5.9% per year among younger (25-69 years) patients while no statistically significant changes occurred among older (70-84 years) patients. Among 47,673 patients discharged alive, without early-onset heart failure, 5.4% experienced late-onset heart failure. The risk of heart failure declined by 6.3% per year (subhazard ratio = 0.937; 95% confidence interval: 0.921-0.954). The decline was statistically significant in both age groups (6.8% per year and 5.9% per year respectively). Overall, the risk of heart failure occurring at any time during the follow up did not change significantly. However, it increased by 3.3% per year in younger patients and declined by 1.5% per year in older patients. Conclusions: Heart failure occurring during acute myocardial infarction hospitalisation accounts for the majority of heart failure cases and is characterised by unfavourable trends, while heart failure rates following acute myocardial infarction discharge declined over the study period.

AB - Aims: Heart failure is a serious complication of acute myocardial infarction, leading to a poor prognosis. We explored trends in the risk of heart failure among patients hospitalised with an incident acute myocardial infarction in Norway during 2001-2009. Methods and results: A total of 69,372 patients were followed for an episode of heart failure occurring either during (early-onset heart failure) or within one year of discharge from the incident acute myocardial infarction hospitalisation (late-onset heart failure). Logistic regression and competing risk regression models were used to explore trends in early and late-onset heart failure respectively. Overall, 17.1% of patients had early-onset heart failure. The odds of heart failure increased by 2.3% per year (odds ratio = 1.023; 95% confidence interval: 1.015-1.031), influenced by an increase of 5.9% per year among younger (25-69 years) patients while no statistically significant changes occurred among older (70-84 years) patients. Among 47,673 patients discharged alive, without early-onset heart failure, 5.4% experienced late-onset heart failure. The risk of heart failure declined by 6.3% per year (subhazard ratio = 0.937; 95% confidence interval: 0.921-0.954). The decline was statistically significant in both age groups (6.8% per year and 5.9% per year respectively). Overall, the risk of heart failure occurring at any time during the follow up did not change significantly. However, it increased by 3.3% per year in younger patients and declined by 1.5% per year in older patients. Conclusions: Heart failure occurring during acute myocardial infarction hospitalisation accounts for the majority of heart failure cases and is characterised by unfavourable trends, while heart failure rates following acute myocardial infarction discharge declined over the study period.

KW - Adult

KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - Female

KW - Heart Failure/diagnosis

KW - Hospital Mortality

KW - Hospitalization

KW - Humans

KW - Incidence

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Myocardial Infarction/diagnosis

KW - Norway/epidemiology

KW - Odds Ratio

KW - Prognosis

KW - Risk Assessment

KW - Risk Factors

KW - Time Factors

U2 - 10.1177/2047487317698568

DO - 10.1177/2047487317698568

M3 - Journal article

C2 - 28436728

SN - 2047-4873

VL - 24

SP - 971

EP - 980

JO - European Journal of Preventive Cardiology

JF - European Journal of Preventive Cardiology

IS - 9

ER -