Temporal Trends in Post Myocardial Infarction Heart Failure and Outcomes Among Older Adults

Ajar Kochar, Jacob A. Doll, Li Liang, Jerry Curran, Eric D. Peterson

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We sought to determine national trends and long term outcomes of post myocardial infarction (MI) heart failure. An MI can be complicated by heart failure; there are limited data describing the contemporary patterns and clinical implications of post-MI heart failure. Methods and Results: We studied patients with an MI aged 65 years or older from 2000 to 2013 in a Medicare database. New-onset heart failure after an MI was defined as either heart failure during the index MI admission or a hospitalization for heart failure within 1 year of the index MI event. A trend analysis of the incidence of heart failure was performed, and differences were examined by Gray tests. The 5-year mortality rates were evaluated and differences among heart failure cohorts were ascertained by Gray tests. There were a total of 1,531,638 patients with an MI and 565,291 patients had heart failure (36.0%). The rate of heart failure during index admission was 32.3% and the frequency of heart failure hospitalization within 1 year was 10.4%. Patients with heart failure were older (81 years vs 77 years). The temporal trend from 2001 to 2012 suggested a decrease in the incidence of heart failure during index admission (2001: 34.7%, 2012: 31.2%, Ptrend <.01), as well as heart failure hospitalization within 1 year (2001: 11.3%, 2012: 8.7%, Ptrend <.01). The 5-year mortality rate among patients without heart failure was 38.4% and for patients with any heart failure it was 68.7%. Conclusions: Post-MI heart failure in older adults occurs in 1 in 3 patients within 1 year; heart failure portends significantly higher long-term mortality.

Original languageEnglish (US)
JournalJournal of Cardiac Failure
DOIs
StateAccepted/In press - 2021

Keywords

  • elderly
  • heart failure
  • Medicare
  • myocardial infarction
  • temporal trends

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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