Influence of heart failure on the prognosis of patients with acute myocardial infarction in southwestern China

Deng,Fuxue; Xia,Yong; Fu,Michael; Hu,Yunfeng; Jia,Fang; Rahardjo,Yeffry; Duan,Yingyi; He,Linjing; Chang,Jing

doi:10.3892/etm.2016.3211

Influence of heart failure on the prognosis of patients with acute myocardial infarction in southwestern China

Authors:
- Fuxue Deng
- Yong Xia
- Michael Fu
- Yunfeng Hu
- Fang Jia
- Yeffry Rahardjo
- Yingyi Duan
- Linjing He
- Jing Chang
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Affiliations: Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 404100, P.R. China, Heart & Lung Research Institute, The Ohio State University College of Medicine, Columbus, OH 43210, USA, Section of Cardiology, Sahlgrenska University Hospital/Östra Hospital, Gothenburg 40530, Sweden, Department of Internal Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 404100, P.R. China
Published online on: March 31, 2016 https://doi.org/10.3892/etm.2016.3211
Pages: 2127-2138
Copyright: © Deng et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The impact of heart failure (HF) on acute myocardial infarction (AMI) in patients from southwestern China remains unclear. The present study aimed to compare in‑hospital cardiovascular events, mortality and clinical therapies in AMI patients with or without HF in southwestern China. In total, 591 patients with AMI hospitalized between February 2009 and December 2012 were examined; those with a history of HF were excluded. The patients were divided into four groups according to AMI type (ST‑elevated or non‑ST‑elevated AMI) and the presence of HF during hospitalization. Clinical characteristics, in‑hospital cardiovascular events, mortality, coronary angiography and treatment were compared. Clinical therapies, specifically evidence‑based drug use were analyzed in patients with HF during hospitalization, including angiotensin converting enzyme inhibitors (ACEIs) and β‑blockers (BBs). AMI patients with HF had a higher frequency of co‑morbidities, lower left ventricular ejection fraction, longer length of hospital stay and a greater risk of in‑hospital mortality compared with AMI patients without HF. AMI patients with HF were less likely to be examined by cardiac angiography or treated with reperfusion therapy or recommended medications. AMI patients with HF co‑treated with ACEIs and BBs had a significantly higher survival rate (94.4 vs. 67.5%; P<0.001) compared with untreated patients or patients treated with either ACEIs or BBs alone. Logistic regression analysis revealed that HF and cardiogenic shock in patients with AMI were the strongest predictors of in‑hospital mortality. AMI patients with HF were at a higher risk of adverse outcomes. Cardiac angiography and timely standard recommended medications were associated with improved clinical outcomes.

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