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Influence of prior myocardial infarction on outcome in patients with ischaemic HFrEF: insights from the EVIdence based TreAtment in Heart Failure (EVITA-HF) registry.
Heer, Tobias; Zeymer, Uwe; Hochadel, Matthias; Frankenstein, Lutz; Pauschinger, Matthias; Hambrecht, Rainer; Bruder, Oliver; Böhm, Michael; Maier, Lars S; Zahn, Ralf; Senges, Jochen.
Afiliação
  • Heer T; Department of Cardiology, München Klinik Neuperlach, Academic Teaching Hospital, LMU University of Munich, Oskar-Maria-Graf-Ring 51, 81737, Munich, Germany. tobias.heer@muenchen-klinik.de.
  • Zeymer U; Department of Cardiology, Klinikum der Stadt Ludwigshafen am Rhein, Ludwigshafen, Germany.
  • Hochadel M; Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany.
  • Frankenstein L; Department of Internal Medicine III, Universitätsklinikum Heidelberg, Heidelberg, Germany.
  • Pauschinger M; Med. Klinik 8 - Kardiologie, Universitätsklinik der Paracelsus Medizinischen Privatuniversität, Klinikum Nürnberg, Nuremberg, Germany.
  • Hambrecht R; Department of Internal Medicine II, Krankenhaus Links der Weser, Bremen, Germany.
  • Bruder O; Department of Cardiology and Angiology, Elisabeth-Krankenhaus Essen, Essen, Germany.
  • Böhm M; Department of Cardiology, Universitätsklinikum des Saarlandes, University of Saarland, Homburg/Saar, Germany.
  • Maier LS; Department of Internal Medicine II, Universitätsklinikum Regensburg, Regensburg, Germany.
  • Zahn R; Department of Cardiology, Klinikum der Stadt Ludwigshafen am Rhein, Ludwigshafen, Germany.
  • Senges J; Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany.
Clin Res Cardiol ; 2024 May 08.
Article em En | MEDLINE | ID: mdl-38717480
ABSTRACT

BACKGROUND:

There is scarce information about the influence of prior myocardial infarction (pMI) on outcomes in patients (pts) with ischaemic HFrEF. We analysed data from the EVIdence based TreAtment in Heart Failure (EVITA-HF) registry.

METHODS:

EVITA-HF comprises web-based case report data on demography, diagnostic measures, adverse events and 1-year follow-up of patients hospitalized for chronic heart failure ≥ 3 months (CHF) and an ejection fraction ≤ 40%. In the present study, we focused on the outcomes of pts with and without pMI in ischaemic HFrEF.

RESULTS:

Between February 2009 and November 2015, a total of 2075 consecutive pts with ischaemic HFrEF were included from 16 centres in Germany. A total of 81.2% were male, and the mean age was 71 years. A total of 61.5% of the pts with ischaemic HFrEF had a history of pMI. These pts were treated less often with PCI (20.0 vs. 31.0%, p < 0.001) or CABG (3.8 vs. 7.7%, p < 0.001). They more often received an ICD (40.9 vs. 28.7%, p < 0.001), but less often a CRT-D (11.3 vs. 19.4%, p < 0.001). After multivariate adjustment, pts with pMI had a greater all-cause mortality after 1 year than those without pMI (hazard ratio 1.4; 95% CI, 1.10-1.79, p = 0.007). The combined endpoint of death, resuscitation or ICD shock after 1 year was greater in patients with pMI (20.8 vs. 16.4%, p = 0.03). Mobility was more often reduced in pts with pMI (46.8% vs. 40.1%, p = 0.03), and overall health status was more frequently worse in patients with pMI than in those 12 months ago (23.1 vs. 15.9%, p = 0.01). More than a quarter of the pts with ischaemic HFrEF were anxious or depressive.

CONCLUSION:

pMI in patients with CHF and ischaemic HFrEF was associated with increased mortality, increased event rates, and worsened health status. Hence, the subgroup of pts with ischaemic HFrEF and pMI is at higher risk and deserves special attention.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Clin Res Cardiol Assunto da revista: CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Clin Res Cardiol Assunto da revista: CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Alemanha