Among 83,357 ACS survivors without prior HF, 23.3% developed incident HF within 10 years, which was associated with 3.44-fold higher mortality and 2.75-fold higher major cardiac events.
Incident heart failure affects nearly one-quarter of ACS survivors within 10 years and is strongly driven by both clinical factors and socioeconomic vulnerability, leading to markedly worse clinical and economic outcomes.
Tasa de eventos absoluta: 0% vs 0%
Introduction and objectives: Incident heart failure (iHF) impacts the downstream cardiovascular disease continuum, particularly after acute coronary syndromes (ACS). The aim of this study was to assess iHF after ACS from a population-based perspective, identify its risk factors, and analyze the associated clinical and resource burden. Methods: Retrospective, population-based study including all individuals covered by the Catalonian public health care system, who were discharged after an ACS between January 1, 2011 and December 31, 2021. Integrated health care databases from multiple sources were used. Results: Among 83 357 patients without previous HF who were discharged after ACS, 23.3% developed iHF during follow-up. The main risk factors for developing iHF after ACS included age (sHR, per year 1.03; 95%CI, 1.03-1.04), very low income (sHR, 2.08; 95%CI, 1.56-2.78), and Killip class II-III at presentation (sHR, 2.16; 95%CI, 2.06-2.27). Compared with patients without iHF, those who developed iHF had markedly higher rates of all-cause mortality (3.44-fold), major adverse cardiac events (2.75-fold), and substantially greater health care expenditure, mainly driven by hospitalizations. Conclusions: One in 4 ACS survivors developed HF within 10 years, with major consequences for survival, morbidity, and health care costs. Socioeconomic status emerged as a determinant comparable to traditional clinical risk factors, suggesting the importance of targeted strategies to improve early identification and prevention of HF after ACS, particularly in socioeconomically vulnerable populations. Registered at ClinicalTrials.gov (NCT06255418). Introducción y objetivos: La insuficiencia cardiaca incidente (ICI) impacta en la evolución de la enfermedad cardiovascular, especialmente tras un síndrome coronario agudo (SCA). El objetivo del estudio fue evaluar la ICI tras un SCA, identificar sus factores de riesgo, y analizar la carga clínica y utilización de recursos asociada. Métodos: Estudio retrospectivo y poblacional que incluyó a todos los pacientes del sistema público de salud de Cataluña dados de alta tras un SCA entre el 1 de enero de 2011 y el 31 de diciembre de 2021. Se utilizaron bases de datos sanitarias integradas de múltiples fuentes. Resultados: El 23,3% de los 83.357 pacientes sin insuficiencia cardiaca previa, dados de alta tras un SCA, desarrollaron ICI durante el seguimiento. Los principales factores de riesgo para la ICI fueron la edad (sHR anual = 1,03; IC95%, 1,03-1,04), un nivel socioeconómico muy bajo (sHR = 2,08; IC95%, 1,56-2,78) y la clase Killip II-III (sHR = 2,16; IC95%, 2,06-2,27). Los pacientes con ICI presentaron comparativamente una mortalidad 3,44 veces mayor, una tasa de eventos cardiovasculares adversos mayores 2,75 veces superior y un gasto sanitario significativamente más alto, principalmente por hospitalizaciones. Conclusiones: Uno de cada 4 supervivientes desarrolló ICI tras un SCA, con un impacto relevante en morbimortalidad y costes sanitarios. El nivel socioeconómico emergió como un determinante comparable a los factores clínicos tradicionales, lo que sugiere la potencial importancia de estrategias de identificación precoz y prevención, especialmente en poblaciones vulnerables. Registrado en ClinicalTrials.gov (NCT06255418).
Colet et al. (Sun,) reported a other. Among 83,357 ACS survivors without prior HF, 23.3% developed incident HF within 10 years, which was associated with 3.44-fold higher mortality and 2.75-fold higher major cardiac events.