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Eur J Intern Med. 2014 Oct;25(8):731-8. doi: 10.1016/j.ejim.2014.08.009. Epub 2014 Sep 16.

Nationwide trends in development of heart failure and mortality after first-time myocardial infarction 1997-2010: A Danish cohort study.

Author information

1
Department of Cardiology, Niels Andersens Vej 65, Gentofte University Hospital, 2900 Hellerup, Denmark. Electronic address: anne@gjesing.com.
2
Department of Cardiology, Niels Andersens Vej 65, Gentofte University Hospital, 2900 Hellerup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen N, Denmark; National Institute of Public Health, University of Southern, Øster Farimagsgade 5 A, 1353 Copenhagen K, Denmark.
3
Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen N, Denmark; Department of Cardiology, The Heart Centre, Rigshospitalet, Blegdamsvej 9, Copenhagen University Hospital, 2100 Copenhagen Ø, Denmark.
4
Department of Cardiology, Lund University, Paradisgatan 2, 221 00 Lund, Sweden; Department of Heart Failure and Valvular Disease, Skåne University Hospital, Paradisgatan 2, 221 00 Lund, Sweden; Department of Clinical Sciences, Clinical Research Centre, Skåne University Hospital, Jan Waldenströms Gata 35, Malmö, Sweden.
5
Department of Cardiology, Niels Andersens Vej 65, Gentofte University Hospital, 2900 Hellerup, Denmark.
6
Department of Cardiology, The Heart Centre, Rigshospitalet, Blegdamsvej 9, Copenhagen University Hospital, 2100 Copenhagen Ø, Denmark.
7
Institute of Health, Science and Technology, Aalborg University, Fredrik Bajers Vej 7D2, 9220 Aalborg, Denmark.
8
Department of Cardiology, Niels Andersens Vej 65, Gentofte University Hospital, 2900 Hellerup, Denmark; Department of Clinical Sciences, Clinical Research Centre, Skåne University Hospital, Jan Waldenströms Gata 35, Malmö, Sweden.

Abstract

AIMS:

Pharmacological and revascularization strategies following myocardial infarction (MI) have changed substantially during the last two decades. We investigated the temporal trends in heart failure (HF) incidence and mortality during the first 90 days following first-time MI between 1997 and 2010 in Denmark.

METHODS AND RESULTS:

Through administrative nationwide registers we identified 89,389 patients without prior HF hospitalized with first MI. The number of patients treated with percutaneous coronary intervention (PCI) days 0-1 after index MI increased from 2.5% in 1997-98 to 38.2% in 2009-10. Treatment with clopidogrel increased from 0.02% in 1997-98 to 68.1% in 2009-10 and statins from 8.1% in 1997-98 to 78.3% in 2009-10. The incidence of HF (defined as HF diagnosis or incident use of loop diuretics) decreased from 23.6% in 1997-98 to 19.6% in 2009-10 (p<0.001). Adjusted for age, sex, and comorbidity, hazard ratio was 0.77 (95% confidence interval [CI] 0.74-0.79) for developing HF in 2009-10, compared with 1997-98. Adjusted for coronary interventions, and pharmacotherapy HR increased to 0.82 (95% confidence interval (CI) 0.79-0.85) compared with 1997-98. The 90-day mortality decreased from 19.6% in 1997-98 to 11.7% in 2009-10 (p<0.001). Adjusted for age, sex, and comorbidity HR was 0.59 (CI 0.55-0.64) in 2009-10 compared with 1997-98; upon additional adjustment for coronary interventions and pharmacotherapy the estimate was 0.75 (95% CI 0.69-0.81).

CONCLUSION:

We found a temporal decrease in HF incidence and mortality during the first 90 days after MI in 1997-2010. This could partly be explained by changes in interventional and pharmacological treatment strategies.

KEYWORDS:

Epidemiology; Heart failure; Mortality; Myocardial infarction

PMID:
25225051
DOI:
10.1016/j.ejim.2014.08.009
[Indexed for MEDLINE]
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