Youn Jong-Chan, Seo Suk Min, Lee Hye Sun, Oh Jaewon, Kim Min Seok, Choi Jin-Oh, Lee Hae-Young, Cho Hyun-Jai, Kang Seok-Min, Kim Jae Joong, Baek Sang Hong, Jeon Eun-Seok, Park Hyun-Young, Cho Myeong-Chan, Oh Byung-Hee
Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Cardiovascular Center and Cardiology Division, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.
J Korean Med Sci. 2014 Apr;29(4):544-9. doi: 10.3346/jkms.2014.29.4.544. Epub 2014 Apr 1.
Heart failure (HF) complicating acute myocardial infarction (AMI) is common and is associated with poor clinical outcome. Limited data exist regarding the incidence and in-hospital mortality of AMI with HF (AMI-HF). We retrospectively analyzed 1,427 consecutive patients with AMI in the five major university hospitals in Korea at two time points, 1998 (n = 608) and 2008 (n = 819). Two hundred twenty eight patients (37.5%) in 1998 and 324 patients (39.5%) in 2008 of AMI patients complicated with HF (P = 0.429). AMI-HF patients in 2008 were older, had more hypertension, previous AMI, and lower systolic blood pressure than those in 1998. Regarding treatments, AMI-HF patients in 2008 received more revascularization procedures, more evidence based medical treatment and adjuvant therapy, such as mechanical ventilators, intra-aortic balloon pulsation compared to those in 1998. However, overall in-hospital mortality rates (6.4% vs 11.1%, P = 0.071) of AMI-HF patients were unchanged and still high even after propensity score matching analysis, irrespective of types of AMI and revascularization methods. In conclusion, more evidence-based medical and advanced procedural managements were applied for patients with AMI-HF in 2008 than in 1998. However the incidence and in-hospital mortality of AMI-HF patients were not significantly changed between the two time points.
心力衰竭（HF）并发急性心肌梗死（AMI）很常见，且与不良临床结局相关。关于伴HF的AMI（AMI-HF）的发病率和院内死亡率的数据有限。我们回顾性分析了韩国五家主要大学医院1998年（n = 608）和2008年（n = 819）两个时间点连续收治的1427例AMI患者。1998年228例（37.5%）和2008年324例（39.5%）的AMI患者并发HF（P = 0.429）。2008年的AMI-HF患者比1998年的患者年龄更大，高血压、既往AMI病史更多，收缩压更低。在治疗方面，与1998年相比，2008年的AMI-HF患者接受了更多的血运重建手术、更多基于证据的药物治疗和辅助治疗，如机械通气、主动脉内球囊反搏。然而，即使在倾向评分匹配分析后，AMI-HF患者的总体院内死亡率（6.4%对11.1%，P = 0.071）没有变化，仍然很高，无论AMI类型和血运重建方法如何。总之，2008年对AMI-HF患者应用了比1998年更多基于证据的药物和先进的手术管理。然而，两个时间点之间AMI-HF患者的发病率和院内死亡率没有显著变化。
