Therapies to prevent heart failure post-myocardial infarction.
Heart failure (HF) is a common complication of myocardial infarction (MI) that carries a poor prognosis when present. HF and/or left ventricular systolic dysfunction (LVSD) occur in approximately 40% of patients who suffer acute MI. The estimated mortality of patients developing HF or LVSD post-MI is 20% to 30%, with that risk varying based on the presence of HF upon initial assessment versus occurring later during the MI hospitalization. Clinical factors and comorbidities associated with post-MI HF include age, diabetes, hypertension, female gender, infarct size, and tachycardia. Factors associated with decreased survival in patients with post-MI HF include Killip class, age, low blood pressure, tachycardia, male gender, and anterior location of MI. Despite extensive data identifying this patient population as high risk, patients with post-MI HF or LVSD are significantly less likely to receive evidence-based medications or revascularization procedures than those without HF. Despite the high prevalence of HF after MI, few studies have examined therapies to prevent it. This review summarizes studies that reported the incidence, risk factors, and outcomes of patients with post-MI HF or LVSD. Additionally, we discuss therapies to prevent post-MI HF and treatment of patients with post-MI HF and/or LVSD.
Thomas
Kevin L
KL
Duke University Medical Center, 2400 Pratt Street, Durham, NC 27710, USA.
Velazquez
Eric J
EJ
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D004554:Electric Countershock / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D006333:Heart Failure / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D010975:Platelet Aggregation Inhibitors