Document Detail

The timing of development and subsequent clinical course of heart failure after a myocardial infarction.
MedLine Citation:
PMID:  18353754     Owner:  NLM     Status:  MEDLINE    
AIMS: Myocardial infarction (MI) is a common cause of heart failure (HF), which may develop early and persist or resolve, or develop late. The cumulative incidence, persistence, and resolution of HF after MI are poorly described. The aim of this study is to describe the natural history and prognosis of HF after an MI. METHODS AND RESULTS: Patients with a death or discharge diagnosis of MI in 1998 were identified from records of hospitals providing services to a local community of 600 000 people. Records were scrutinized to identify the development of HF, defined as signs and symptoms consistent with that diagnosis and treated with loop diuretics. HF was considered to have resolved if diuretics could be stopped without recurrent symptoms. Totally, 896 patients were identified of whom 54% had died by December 2005. During the index admission, 199 (22.2%) patients died, many with HF, and a further 182 (20.3%) patients developed HF that persisted until discharge, of whom 121 died subsequent to discharge. Of 74 patients with transient HF that resolved before discharge, 41 had recurrent HF and 38 died during follow-up. After discharge, 145 (33%) patients developed HF for the first time, of whom 76 died during follow-up. Overall, of 281 deaths occurring after discharge, 235 (83.6%) were amongst inpatients who first developed HF. CONCLUSION: The development of HF precedes death in most patients who die in the short- or long-term following an MI. Prevention of HF, predominantly by reducing the extent of myocardial damage and recurrent MI, and subsequent management could have a substantial impact on prognosis.
Azam Torabi; John G F Cleland; Nasrin K Khan; Puan H Loh; Andrew L Clark; Farqad Alamgir; John L Caplin; Alan S Rigby; Kevin Goode
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-03-19
Journal Detail:
Title:  European heart journal     Volume:  29     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-02     Completed Date:  2008-11-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  859-70     Citation Subset:  IM    
Department of Cardiology, Hull Royal Infirmary, University of Hull Castle Hill Hospital, Kingston-upon-Hull, Castle Road, Cottingham, East Yorkshire HU16 5JQ, UK.
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MeSH Terms
Aged, 80 and over
Cause of Death
Heart Failure / etiology*,  mortality
Hospital Mortality
Hospitalization / statistics & numerical data
Middle Aged
Myocardial Infarction / complications*
Retrospective Studies
Risk Factors
Stroke Volume / physiology
Comment In:
Eur Heart J. 2008 Apr;29(7):833-4   [PMID:  18353755 ]

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