title: The timing of development and subsequent clinical course of heart failure after a myocardial infarction.
abstract: OBJECTIVE
  Myocardial infarction (MI) is a common cause of heart failure (HF), which may develop early and persist or resolve, or develop late. The cumulative incidence, persistence, and resolution of HF after MI are poorly described. The aim of this study is to describe the natural history and prognosis of HF after an MI.
  
  
  RESULTS
  Patients with a death or discharge diagnosis of MI in 1998 were identified from records of hospitals providing services to a local community of 600 000 people. Records were scrutinized to identify the development of HF, defined as signs and symptoms consistent with that diagnosis and treated with loop diuretics. HF was considered to have resolved if diuretics could be stopped without recurrent symptoms. Totally, 896 patients were identified of whom 54% had died by December 2005. During the index admission, 199 (22.2%) patients died, many with HF, and a further 182 (20.3%) patients developed HF that persisted until discharge, of whom 121 died subsequent to discharge. Of 74 patients with transient HF that resolved before discharge, 41 had recurrent HF and 38 died during follow-up. After discharge, 145 (33%) patients developed HF for the first time, of whom 76 died during follow-up. Overall, of 281 deaths occurring after discharge, 235 (83.6%) were amongst inpatients who first developed HF.
  
  
  CONCLUSIONS
  The development of HF precedes death in most patients who die in the short- or long-term following an MI. Prevention of HF, predominantly by reducing the extent of myocardial damage and recurrent MI, and subsequent management could have a substantial impact on prognosis.
authors: Department of Cardiology, Hull Royal Infirmary, University of Hull Castle Hill Hospital, Kingston-upon-Hull, Castle Road, Cottingham, East Yorkshire HU16 5JQ, UK.
authors: Azam
authors: A
authors: Torabi
authors: John G F
authors: JG
authors: Cleland
authors: Nasrin K
authors: NK
authors: Khan
authors: Puan H
authors: PH
authors: Loh
authors: Andrew L
authors: AL
authors: Clark
authors: Farqad
authors: F
authors: Alamgir
authors: John L
authors: JL
authors: Caplin
authors: Alan S
authors: AS
authors: Rigby
authors: Kevin
authors: K
authors: Goode
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002423:Cause of Death; D004739:England; D005260:Female; D006333:Heart Failure / Q000209:etiology* / Q000401:mortality; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology