Heart Failure Risk Surpasses Recurrent MI risk After Acute Heart Attack, reveals study
A new study published in the European Heart Journal has found that patients who have experienced a heart attack (myocardial infarction (MI)) are at a higher risk of having newly developed heart failure (HF) than of having another heart attack. A large retrospective study from 6,804 patients demonstrated that patients without prior HF developed new-onset HF within a year. This study was conducted by Javed B. and fellow researchers.
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
