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August 22, 2017European Heart Journal Acute Cardiovascular CareOpen Access

Correlates and prognostic impact of new-onset heart failure after ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention: insights from the INFUSE-AMI trial

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Key result

Early post-STEMI NYHA class ≥2 is linked to ~278% higher 1-year death or HF hospitalization risk.

  • HR 3.78
  • 95% CI 1.16-12.22
  • P=0.03
  • n=402

Why the study?

Does early post-discharge heart failure (NYHA class ≥2) increase the risk of death or hospitalization for heart failure in STEMI patients treated with primary PCI?

Population

402 patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary…

Comparison

New York Heart Association functional class ≥2… vs New York Heart Association functional class 1 at…

Design

Cohort

Follow-up

1-year

Authors

GGGennaro GiustinoBRBjörn RedforsSBSorin J. Brener

Discussion

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Overview

Early post-discharge NYHA ≥2 symptoms flag high-risk STEMI patients after PCI; hypothesis-generating for targeted intervention trials.

Study Design

Type

Cohort (n=402)

Structured PICO

Does early post-discharge heart failure (NYHA class ≥2) increase the risk of death or hospitalization for heart failure in STEMI patients treated with primary PCI?

P
Population
402 patients with STEMI treated with primary PCI from the INFUSE-AMI trial, categorized by NYHA class at 30 days and followed for 1 year.
E
Exposure
New York Heart Association (NYHA) functional class ≥2 at 30-day visit
C
Comparator
New York Heart Association (NYHA) functional class 1 at 30-day visit
O
Outcome
Composite of death or hospitalization for heart failure at 1-year follow-up (landmark analysis beyond 30 days)composite

Main Result

Hazard Ratio: 3.78 (95% CI 1.16–12.22)

Absolute Event Rate: 11.8% vs 2.8%

p-value: p=0.03

Early post-discharge heart failure symptoms (NYHA class ≥2) identify a high-risk cohort for subsequent death or heart failure hospitalization in STEMI patients treated with primary PCI, independent of infarct size.

Cite This Study

Giustino et al. (2017) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=402). NYHA class ≥2 at 30 days vs. NYHA class 1 at 30 days was evaluated on death or hospitalization for heart failure (HR 3.78, 95% CI 1.16-12.22, p=0.03). Early post-discharge heart failure symptoms (NYHA class ≥2) after STEMI were associated with a higher 1-year risk of death or heart failure hospitalization (11.8% vs 2.8%; HR 3.78; P=0.03).

synapsesocial.com/papers/6aade73db815c3f3d1b31e32https://doi.org/10.1177/2048872617719649
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