Heart Failure Risk Surpasses Recurrent MI risk After Acute Heart Attack, reveals study

The study involved 6,804 patients who were hospitalized with a primary discharge diagnosis of MI between January 2015 and December 2021. The researchers evaluated patient characteristics, treatments, and 1-year post-discharge outcomes, including rates of recurrent MI, incident HF, all-cause death, and rehospitalizations. The landmark approach was applied at three months post-discharge to evaluate one-year outcomes in patients who survived beyond this period (6,210 patients).

Key Findings

• Patient demographics: Median age was 69 years, and 59.7% were males and 76.7% NSTEMI.

Common comorbidities:

• Hypertension: 89%

• Dyslipidemia: 87%

• Type 2 diabetes: 48%

• CKD: 34%Prior MI: 17%

• Pre-existing HF: 23%

Revascularization procedures: 63% underwent percutaneous or surgical revascularization to restore blood flow.

1-year post-discharge outcomes:

• Deaths: 6.7% (413 patients)

• All-cause hospitalizations: 27.9% (1,730 patients)

• Cardiovascular hospitalizations: 11.8% (735 patients)

• Recurrent MI: 3.8% (234 patients)

Heart failure incidence:

• Among 4,876 patients without prior HF, 23.8% (1,160 patients) developed new-onset HF within a year.

Ejection fraction (EF) distribution among new HF cases:

• EF <40%: 42.2

• EF 41 - 49 %: 26.7

• EF >50 %: 31.1

Increased risk even in patients with normal EF:

• Among 2,179 patients with EF >50% and no prior HF, 11.8% (257 patients) developed HF, and 3.5% (77 patients) experienced a recurrent MI within a year.

• HF Worsens Outcomes: Patients who developed HF irrespective of EF had greater risks of mortality and hospitalization rates (all p<0.001).

Researchers concluded that the risk of HF following a MI to be significantly greater than having a recurrent MI, even among patients with preserved EF. Significant effects on mortality and hospitalization warrant proactive approaches for HF prevention among post-MI patients and can improve their long-term prognosis while reducing health care burden.

Reference:

Javed Butler, Kendall Hammonds, Khawaja M Talha, Ayman Alhamdow, Monica M Bennett, J Vee Anne Bomar, Jason A Ettlinger, Monica Martinez Traba, Elisa L Priest, Niklas Schmedt, Cecilia Zeballos, Courtney N Shaver, Aasim Afzal, Robert J Widmer, Robert L Gottlieb, Michael J Mack, Milton Packer, Incident heart failure and recurrent coronary events following acute myocardial infarction, European Heart Journal, 2025;, ehae885, https://doi.org/10.1093/eurheartj/ehae885