Health Insurance Review and Assessment Service, Wonju 26465, Korea.
Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea.
Int J Environ Res Public Health. 2021 Jun 8;18(12):6207. doi: 10.3390/ijerph18126207.
Heart failure (HF) is the major mechanism of mortality in acute myocardial infarction (AMI) during early or intermediate post-AMI period. But heart failure is one of the most common long-term complications of AMI. Applied the retrospective cohort study design with nation representative population data, this study traced the incidence of late-onset heart failure since 1 year after newly developed acute myocardial infarction and assessed its risk factors. Using the Korea National Health Insurance database, 18,328 newly developed AMI patients aged 40 years or older and first hospitalized in 2010 for 3 days or more, were set up as baseline cohort (12,403). The incidence rate of AMI per 100,000 persons was 79.8 overall, and 49.6 for women and 112.3 for men. A total of 2010 (1073 men, 937 women) were newly developed with HF during 6 years following post AMI. Cumulative incidences of HF per 1000 AMI patients for a year at each time period were 37.4 in initial hospitalization, 32.3 in 1 year after discharge, and 8.9 in 1-6 years. The overall and age-specific incidence rates of HF were higher in women than men. For late-onset HF, female, medical aid, pre-existing hypertension, severity of AMI, duration of hospital stay during index admission, reperfusion treatment, and drug prescription pattern including diuretics, affected the occurrence of late-onset HF. With respect to late-onset HF following AMI, appropriate management including hypertension and medical aid program in addition to quality improvement of AMI treatment are required to reduce the risk of late-onset heart failure.
心力衰竭（HF）是急性心肌梗死（AMI）早期或中期死亡的主要机制。但心力衰竭是 AMI 的最常见长期并发症之一。本研究采用回顾性队列研究设计，利用具有代表性的全国人群数据，追踪了新发急性心肌梗死后 1 年发生的迟发性心力衰竭的发病率，并评估了其危险因素。利用韩国国家健康保险数据库，将 2010 年首次住院 3 天或以上的 18328 例年龄在 40 岁或以上的新发 AMI 患者设为基线队列（12403 例）。AMI 的发病率为每 10 万人 79.8 例，其中女性为 49.6 例，男性为 112.3 例。共有 2010 例（1073 例男性，937 例女性）在 AMI 后 6 年内新发 HF。每个时间段每 1000 例 AMI 患者 HF 的 1 年累积发生率分别为入院时的 37.4%、出院后 1 年的 32.3%和 1-6 年的 8.9%。HF 的总体和年龄特异性发病率在女性中高于男性。对于迟发性 HF，女性、医疗补助、预先存在的高血压、AMI 的严重程度、指数入院期间的住院时间、再灌注治疗以及包括利尿剂在内的药物处方模式都影响迟发性 HF 的发生。对于 AMI 后的迟发性 HF，需要进行适当的管理，包括高血压和医疗补助计划，以及改善 AMI 的治疗质量，以降低迟发性心力衰竭的风险。
