Many Patients Develop Heart Failure Within 4 Years of Heart Attack

Approximately 25% of patients develop heart failure within 4 years after the patients’ first heart attack.

A recent study found that within 4 years of their first heart attack, 1 in 4 patients will develop heart failure. Age, socioeconomic standing, and other health conditions were seen to have an impact on the development of heart failure as well.

The study was presented at Heart Failure 2016 and the 3rd World Congress on Acute Heart Failure.

"Heart failure is a major medical problem with a high chance of hospitalization and death. Patients with ischaemic heart disease are at the highest risk. This includes those who have had a myocardial infarction, also called heart attack,” said researcher Johannes Gho, MD. "Research studying incidence of heart failure following myocardial infarction is limited and mainly stems from the thrombolytic era, when drugs were used to dissolve blood clots. Today the preferred treatment for acute myocardial infarction is percutaneous coronary intervention (PCI) where a stent is used to open the blocked artery.”

The study collected electronic health records to identify which patients were the most likely to develop heart failure. Researchers included 24,745 patients 18 years and older who had their first myocardial infarction between January 1998 and March 2010 and who had no prior history of heart failure, according to the study.

Researchers found that 6005 (24.3%) of patients developed heart failure.

"Around 1 in 4 patients developed heart failure within four years of a first myocardial infarction in the current era. This was relatively stable over time possibly due to 2 competing trends,” Dr Gho said. “On the one hand, PCI has improved treatment for myocardial infarction so the risk of heart failure would be expected to decrease. On the other hand, because treatment has improved, more patients are alive after a heart attack to subsequently get heart failure."

Researchers also found that other factors increased patients’ risk of developing heart failure. With every 10-year age increase, there was a 45% increased risk of developing heart failure, according to the study.

Also, researchers found that patients coming from lower socioeconomic backgrounds had a 27% increased risk.

Various conditions were also associated with an increased risk of developing heart failure: diabetes (44% increased risk), atrial fibrillation (63% increased risk), peripheral arterial disease (38% increased risk), chronic obstructive pulmonary disease (28% increased risk), ST elevation myocardial infarction at presentation (21% increased risk), and hypertension (16% increased risk), according to the study.

"Previous research looking at all cause heart failure, not only after myocardial infarction, has found similar risk factors. Our large cohort study confirms that these are also risky conditions for heart attack patients in the current era,” Dr Gho concluded. "Identifying these prognostic factors in heart attack patients could help us predict their risk of developing heart failure and allow us to give treatments to reduce that risk."