National Trends in Heart Failure Hospitalization After Acute Myocardial Infarction for Medicare Beneficiaries
Key result
Heart failure hospitalization within 1 year after AMI among Medicare beneficiaries declined from 16.1 per 100 person-years in 1998 to 14.2 in 2010 (IRR 0.854; 95% CI 0.809-0.901; P<0.001).
Population
2,789,943 acute myocardial infarction hospitalizations of Medicare fee-for-service beneficiaries from 1998…
Design
Cohort
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
Suggests care gains in preventing post-AMI HF among elderly; extends temporal trends but leaves survival after HF open.
Key Points
- Investigate national trends in heart failure hospitalization following acute myocardial infarction among Medicare beneficiaries over time.
- Analyzed 2,789,943 AMI hospitalizations of Medicare beneficiaries from 1998 to 2010.
- Used Poisson and survival analysis models to evaluate hospitalization and mortality trends.
- Adjusted for demographic factors and clinical comorbidities.
- HF hospitalization declined from 16.1 to 14.2 per 100 person-years from 1998 to 2010 (P<0.001).
- Adjusted for demographics, a relative 14.6% decline in HF hospitalizations after AMI was noted (incidence risk ratio 0.854, 95% CI 0.809-0.901).
- Unadjusted 1-year mortality after HF hospitalization fluctuated, showing a 5.1% increase from 2007 to 2010 (hazard ratio 1.051, 95% CI 1.039-1.064).
Study Design
Type
Observational (n=2,789,943)
Multicenter
Yes
Structured PICO
P
Population
2,789,943 acute myocardial infarction (AMI) hospitalizations of Medicare fee-for-service beneficiaries from 1998 through 2010
O
Outcome
Incidence of subsequent heart failure (HF) hospitalization and mortality within 1 year after AMIhard clinical
Main Result
Effect estimate: IRR 0.854 (95% CI 0.809-0.901)
Absolute Event Rate: 14.2% vs 16.1%
p-value: p=<0.001
While the incidence of heart failure hospitalization after acute myocardial infarction has decreased among Medicare beneficiaries, survival after post-AMI heart failure remains poor and has worsened in recent years.
Cite This Study
Chen et al. (2013) conducted an observational in Acute Myocardial Infarction (n=2,789,943). Temporal trends (1998 to 2010) was evaluated on Incidence of subsequent HF hospitalization within 1 year after AMI (IRR 0.854, 95% CI 0.809-0.901, p=<0.001). Heart failure hospitalization within 1 year after AMI among Medicare beneficiaries declined from 16.1 per 100 person-years in 1998 to 14.2 in 2010 (IRR 0.854; 95% CI 0.809-0.901; P<0.001).