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Decreasing trends in the incidence of heart failure after acute myocardial infarction from 1993-2004: a study of 175,216 patients with a first acute myocardial infarction in Sweden

Journal article
Authors Masoud Shafazand
Annika Rosengren
Georg Lappas
Karl Swedberg
Maria Schaufelberger
Published in European journal of heart failure
Volume 13
Issue 2
Pages 135-41
ISSN 1879-0844
Publication year 2011
Published at Institute of Medicine, Department of Emergeny and Cardiovascular Medicine
Pages 135-41
Language en
Links dx.doi.org/10.1093/eurjhf/hfq205
Keywords Adult, Age Distribution, Aged, Aged, 80 and over, Female, Heart Failure/diagnosis/*epidemiology/etiology, Hospital Mortality/*trends, Hospitalization/statistics & numerical data, Humans, Incidence, Male, Middle Aged, Multivariate Analysis, Myocardial Infarction/complications/diagnosis/*epidemiology, Prognosis, Registries, Retrospective Studies, Risk Assessment, Severity of Illness Index, Sex Distribution, Stroke/complications/diagnosis/*epidemiology, Survival Analysis, Sweden/epidemiology
Subject categories Medical and Health Sciences

Abstract

Aims To investigate temporal trends in the risk of heart failure (HF) complicating acute myocardial infarction (AMI) and to determine whether these trends differ by gender or age. Methods and results The national Swedish hospital discharge and death registries from 1993 to 2004 were used to calculate age- and gender-specific trends for a first episode of HF within 3 years in 175 216 patients aged 35–84 and hospitalized with a first AMI. Overall, 14.4% of patients aged 35–64 and 31.5% of those aged 65–84 with AMI in 1993–1995 had a hospital diagnosis of HF within 3 years (including the index admission). Corresponding figures for patients with AMI from 2002 to 2004 were 11.5 and 28.0%, respectively. In multivariable analyses, the risk of HF decreased by 4% per year. Having had a stroke before admission increased HF risk by 37%, diabetes increased the risk by 76% and atrial fibrillation by 80%. Patients with any kind of valvular disease had a more than doubled risk. Women had a 6% higher incidence of HF than men, whereas men with an index admission for AMI who did not develop HF had higher mortality than women. Conclusions In this national sample, we observed a steady decrease in the risk of being hospitalized with HF after an AMI. However, the 3-year risk of HF remains high, with nearly one-third of AMI patients aged 65–84 developing HF within 3 years.

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