Late-onset heart failure after myocardial infarction: Trends in incidence and survival

Abstract

Background: Limited data are available on the epidemiology of heart failure (HF) after acute myocardial infarction (AMI). We have investigated trends in the incidence and outcome of HF developing more than 28 days after first-ever AMI. Methods and results: We identified all residents of Perth, Western Australia aged 25–64 years with no history of HF, who had experienced an AMI between 1984 and 1993, and followed them to 2005 (at which time survivors of the index events would have been aged up to 85 years). Of 3109 patients identified, 406 (13.1%) had at least one subsequent admission to hospital with a diagnosis of HF and 211 died. Following adjustment for age and sex, the hazard ratio for late-onset HF for the period 1989–1993 relative to 1984–1988 was 0.85 (95%CI: 0.69 to 1.04). After adjustment for age, history of diabetes and recurrent acute coronary syndrome, the hazard ratio for death in patients with late-onset HF did not change over the period of study (HR per year=1.02, 95%CI: 0.99 to 1.05). Conclusion: Our findings contradict recent claims that there is an epidemic of HF driven in part by improved survival after AMI.