The following is a summary of “Influence of prior myocardial infarction on outcome in patients with ischaemic HFrEF: insights from the EVIdence based TreAtment in Heart Failure (EVITA-HF) registry,” published in the May 2024 issue of Cardiology by Heer et al.
Information on the influence of previous myocardial infarction (pMI) affects outcomes in patients (pts) with ischemic heart failure with reduced ejection fraction (HFrEF).
Researchers conducted a retrospective study analyzing the impact of pMI on outcomes in pts with ischemic HFrEF.
They used data from the EVIdence based TreAtment in Heart Failure (EVITA-HF) registry, assuring web-based case report data on patient demographics, diagnostic measures, AEs, and 1-year follow-up for patients hospitalized with chronic heart failure (CHF) for ≥3 months and an ejection fraction (EF) ≤40%. The study specifically compared outcomes between pts with and without pMI in ischemic HFrEF.
The results showed that between February 2009 and November 2015, 2,075 consecutive patients with ischemic HFrEF were included from 16 centers in Germany. Most were male (81.2%), with a mean age of 71. About 61.5% had a history of pMI. The pts with pMI received less PCI (20.0% vs. 31.0%, P<0.001) or CABG (3.8 vs 7.7%, P<0.001) but more ICDs (40.9% vs. 28.7%, P<0.001) and less CRT-D (11.3% vs. 19.4%, P<0.001). After adjusting for multiple factors, patients with pMI had higher all-cause mortality after one year (HR 1.4; 95% CI, 1.10-1.79, P=0.007) and a greater incidence of death, resuscitation, or ICD shock after 1 year (20.8% vs. 16.4%, P=0.03). Mobility was often reduced (46.8% vs. 40.1%, P=0.03), and overall health status was worse than 12 months prior in patients with pMI (23.1% vs. 15.9%, P=0.01). Additionally, over a quarter of patients experienced anxiety or depression.
Investigators concluded that pMI in patients with ischemic HFrEF was linked to higher mortality, more events, and worse health status. Therefore, this subgroup requires special attention due to their increased risk.
Source: link.springer.com/article/10.1007/s00392-024-02455-w