Aims To investigate the impact of guideline-directed medical therapy (GDMT) during hospitalization on the prognosis of patients with heart failure (HF) episode complicating post-acute myocardial infarction (AMI). Methods From 01/05/2017 to 30/09/2022, 527 patients with HF episode complicating post-AMI at a single medical center who were retrospectively analyzed. Based on whether GDMT during hospitalization was used in patients undergoing percutaneous coronary intervention (PCI), the patients were divided into the GDMT group ( n = 379) and the non-GDMT group ( n = 148), with a follow-up period of 12 months after PCI. The primary endpoint was the composite endpoint of all-cause death and all-cause readmission. Results The incidence of the primary endpoints (7.9% vs. 18.9%, P 0.001), cardiac death and cardiac readmission composite events (5.5% vs. 15.5%, P = 0.002), all-cause readmission events (7.1% vs. 18.9%, P 0.001), and cardiac readmission events (5.0% vs. 13.5%, P = 0.001) in the GDMT group were lower. Cox regression analysis revealed that the incidence of primary endpoints, cardiac death and cardiac readmission composite events, all-cause readmission events, and cardiac readmission events in patients treated with GDMT during hospitalization were 0.266 times ( HR 0.266; 95% CI 0.146–0.487; P 0.001), 0.282 times ( HR 0.282; 95% CI 0.137–0.581; P = 0.001), 0.251 times ( HR 0.251; 95% CI 0.136–0.464; P 0.001) and 0.262 times ( HR 0.262; 95% CI 0.125–0.551; P 0.001), respectively, compared to patients treated without GDMT. Conclusion For patients with HF episode complicating post-AMI who undergo PCI, the use of GDMT during hospitalization reduces the incidence of primary endpoints, cardiac death and cardiac readmission composite endpoints, and all-cause readmission and cardiac readmission.
Lei et al. (2025) studied this question.