Management and outcomes of acute myocardial infarction in patients with preexisting heart failure: an analysis of 2 million patients from the national inpatient sample

ABSTRACT

Background

Inpatient management and outcomes of patients presenting with acute myocardial infarction (AMI) with a history of heart failure (HF) have not been well characterized.

Methods

Hospitalizations for AMI from the Nationwide Inpatient Sample (2015–2018) were categorized according to a preexisting diagnosis of HF with preserved ejection fraction (HFpEF), reduced ejection fraction (HFrEF), or absence of HF. Utilization of invasive management and in-hospital outcomes were analyzed.

Results

Among 2,434,639 hospitalizations with an AMI, 19.8% had a history of HFrEF and 11.9% had a history of HFpEF. Coronary angiography and PCI respectively were performed significantly less among patients with HF (36.6% and 17.4% in HFpEF, 51.1% and 24.6% in HFrEF, and 64.4% and 42.3% among patients without HF, all p < 0.0001). Mortality was more common among patients with HFrEF (10.3%) and HFpEF (8.3%) when compared to patients without a history of HF (6.4%), p < 0.0001.  

Conclusion

HF is a common preexisting comorbidity among patients presenting with AMI and is associated with lower utilization of invasive procedures and higher complications including mortality, particularly among those with HFrEF.

KEYWORDS:

• Heart failure
• acute myocardial infarction
• revascularization

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

D Abramov: conception and design, analysis and interpretation of data, drafting of the manuscript, critically revising the manuscript for intellectual content, final approval of the version to be published

O Kobo: conception and design, analysis and interpretation of data, drafting of the manuscript, critically revising the manuscript for intellectual content, final approval of the version to be published

M Mohamed: critically revising the manuscript for intellectual content, final approval of the version to be published

A Roguin: critically revising the manuscript for intellectual content, final approval of the version to be published

M Osman: critically revising the manuscript for intellectual content, final approval of the version to be published

B Patel: critically revising the manuscript for intellectual content, final approval of the version to be published

P Parwani: critically revising the manuscript for intellectual content, final approval of the version to be published

C Alraies: critically revising the manuscript for intellectual content, final approval of the version to be published

AJ Sauer: critically revising the manuscript for intellectual content, final approval of the version to be published

HGC Van Spall: critically revising the manuscript for intellectual content, final approval of the version to be published

MA Mamas: conception and design, analysis and interpretation of data, critically revising the manuscript for intellectual content, final approval of the version to be published

Additional information

Funding

This paper was not funded.