Prognostic significance of the occurrence of acute heart failure after successful primary percutaneous coronary intervention.
BACKGROUND
Acute heart failure (AHF) has an adverse impact on short- and long-term outcomes in patients with acute ST-elevation myocardial infarction (STEMI). The aims of the present study were to determine independent predictors for the occurrence of AHF during hospitalization and to assess the impact of AHF on 30-day and 1-year outcomes in patients with STEMI who were successfully treated with primary percutaneous coronary intervention (pPCI).


RESULTS
The study included 1,074 consecutive patients with STEMI who had no signs of heart failure (HF) at admission (Killip class I) and were treated with successful pPCI. Successful PPCI was defined as postprocedural TIMI 3 grade flow. Acute HF developed in 11.1% patients during hospitalization, which was predominantly mild to moderate (Killip classes II and III). Independent predictors for the occurrence of AHF were: anterior infarction, peak creatinine-kinase (CK) > 2,000 U/L and 3-vessel coronary disease. 30-day and 1-year mortality rates were significantly higher in patients with AHF compared to patients without AHF. AHF during hospitalization was an independent predictor of 30-day mortality (hazard ratio [HR] 10.5) and 1-year mortality (HR 4.4).


CONCLUSIONS
Even after successful pPCI, the occurrence of AHF during hospitalization remains an independent predictor of 30-day and 1-year mortality.
Savic
Lidija
L
Clinical Centre of Serbia-Emergency Hospital, Coronary Care Unit, Belgrade, Serbia. lidijasavic@ptt.rs
Mrdovic
Igor
I
Perunicic
Jovan
J
Asanin
Milika
M
Lasica
Ratko
R
Marinkovic
Jelena
J
Vasiljevic
Zorana
Z
Ostojic
Miodrag
M
D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D015994:Incidence; D007297:Inpatients; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D011379:Prognosis; D015996:Survival Rate