One In Four Heart Attack Patients Suffer Heart Failure Within Four Years

Due to improvements in health care, more people are surviving heart attacks. However, one in four patients develop heart failure within four years of their first attack, says a new study.

Johannes Gho, a cardiology resident at the University Medical Center, Utrecht,presented a study of almost 25,000 patients.

"Heart failure is a major medical problem with a high chance of hospitalization and death," Gho said. "Patients with ischemic heart disease are at the highest risk. This includes those who have had a myocardial infarction, also called heart attack."

"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," he added. "Today the preferred treatment for acute myocardial infarction is percutaneous coronary intervention (PCI) where a stent is used to open the blocked artery."

The team looked at electronic health records in order to identify the incidence and risks linked with heart failure after the first heart attack. The data was gathered from the United Kingdom-based Cardiovascular Disease Research Using Linked Bespoke Studies and Electronic Records (CALIBER) program.

Experts studied 24,745 patients who were 18 or older, and who had undergone their first heart attack between Jan. 1, 1988 and March 25, 2010, but without any prior history of heart failure. Later, experts conducted a follow-up for a median of 3.7 years, when 6,005 of the patients developed heart failure.

"Around one in four patients developed heart failure within four years of a first myocardial infarction in the current era," Gho said. "This was relatively stable over time possibly due to two competing trends. 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."

Aging, greater socioeconomic deprivation, atrial fibrillation and diabetes could lead to the heart attacks.

"Previous research looking at all causes of heart failure, not only after myocardial infarction, has found similar risk factors," Gho said. "Our large cohort study confirms that these are also risky conditions for heart attack patients in the current era."

"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," he concluded.

The findings were presented at Heart Failure 2016, an annual conference held by the European Society of Cardiology.