Abramov Dmitry, Kobo Ofer, Mohamed Mohamed, Roguin Ariel, Osman Mohammed, Patel Brijesh, Parwani Purvi, Alraies Chadi, Sauer Andrew J, Van Spall Harriette G C, Mamas Mamas A
Division of Cardiology, Department of Medicine, Loma Linda Health, Loma Linda, CA, USA.
Keele Cardiovascular Research Group, Keele University, Keele, UK.
Expert Rev Cardiovasc Ther. 2022 Mar;20(3):233-240. doi: 10.1080/14779072.2022.2058931. Epub 2022 Mar 31.
Inpatient management and outcomes of patients presenting with acute myocardial infarction (AMI) with a history of heart failure (HF) have not been well characterized.
Hospitalizations for AMI from the Nationwide Inpatient Sample (2015-2018) were categorized according to a preexisting diagnosis of HF with preserved ejection fraction (HFpEF), reduced ejection fraction (HFrEF), or absence of HF. Utilization of invasive management and in-hospital outcomes were analyzed.
Among 2,434,639 hospitalizations with an AMI, 19.8% had a history of HFrEF and 11.9% had a history of HFpEF. Coronary angiography and PCI respectively were performed significantly less among patients with HF (36.6% and 17.4% in HFpEF, 51.1% and 24.6% in HFrEF, and 64.4% and 42.3% among patients without HF, all < 0.0001). Mortality was more common among patients with HFrEF (10.3%) and HFpEF (8.3%) when compared to patients without a history of HF (6.4%), < 0.0001.
HF is a common preexisting comorbidity among patients presenting with AMI and is associated with lower utilization of invasive procedures and higher complications including mortality, particularly among those with HFrEF.
急性心肌梗死（AMI）合并心力衰竭（HF）病史患者的住院管理及预后尚未得到充分描述。
根据全国住院患者样本（2015 - 2018年）中急性心肌梗死患者既往是否存在射血分数保留的心力衰竭（HFpEF）、射血分数降低的心力衰竭（HFrEF）或无心力衰竭情况进行分类。分析侵入性治疗的使用情况及院内结局。
在2434639例急性心肌梗死住院患者中，19.8%有HFrEF病史，11.9%有HFpEF病史。心力衰竭患者接受冠状动脉造影和经皮冠状动脉介入治疗（PCI）的比例显著较低（HFpEF患者分别为36.6%和17.4%，HFrEF患者分别为51.1%和24.6%，无心力衰竭患者分别为64.4%和42.3%，均P < 0.0001）。与无心力衰竭病史的患者（6.4%）相比，HFrEF患者（10.3%）和HFpEF患者（8.3%）的死亡率更高（P < 0.0001）。
心力衰竭是急性心肌梗死患者常见的合并症，与侵入性治疗的低使用率及包括死亡在内的更高并发症发生率相关，尤其是在HFrEF患者中。
