title: Heart failure in acute myocardial infarction: a comparison between patients with or without heart failure criteria from the FAST-MI registry.
abstract: OBJECTIVE
  To compare acute myocardial infarction patients with or without congestive heart failure in the French FAST-MI registry.
  
  
  METHODS
  The French FAST-MI registry included 374 centers and 3059 patients over a 1-month period at the end of 2005, with 1-year follow-up. Among this population, patients with at least one congestive heart failure criterion constituted group 1 (n=1149; 37.5%) and were compared to patients without congestive heart failure (group 2, n=1910; 62.5%). The congestive heart failure patients were further divided according to presence of both beta-blockers and antagonists of the renin-angiotensin-aldosterone system at hospital discharge (n=511) or not (n=498), in order to assess the real-world clinical importance of recommended medications.
  
  
  RESULTS
  Overall in-hospital and 1-year mortality rates were 3.4% and 13.2%, respectively. In hospital survivors, presence of congestive heart failure was associated with increased mortality (adjusted hazard ratio: 1.55; 95% confidence interval, 1.10-2.17; P=.01). Survival was higher in patients without congestive heart failure, compared with congestive heart failure patients receiving or not recommended medications (P<.001). Congestive heart failure patients receiving neither renin-angiotensin-aldosterone system blockers nor beta-blockers (adjusted hazard ratio: 1.66; 95% confidence interval, 1.08-2.55; P=.02) had a significantly higher risk of death than patients receiving both classes of medications (adjusted hazard ratio: 1.16; 95% confidence interval, 0.82-1.64; not statistically significant). Patients receiving only one of the recommended classes had an intermediate risk (adjusted hazard ratio: 1.47; 95% confidence interval, 1.04-2.07; P=.03).
  
  
  CONCLUSIONS
  Patients admitted for acute myocardial infarction with congestive heart failure criteria are still at very high risk of mortality. When receiving major recommended medications, they presented with significantly reduced mortality rates. Additional efforts should therefore be made to encourage the prescription of recommended medications in acute myocardial infarction patients with congestive heart failure.
authors.affiliation: Département de Cardiologie, Centre Hospitalier Universitaire, Nancy-Brabois-Vandoeuvre-les-Nancy, France. y.juilliere@chu-nancy.fr
authors.forename: Yves
authors.initials: Y
authors.lastname: Juillière
authors.forename: Jean P
authors.initials: JP
authors.lastname: Cambou
authors.forename: Vincent
authors.initials: V
authors.lastname: Bataille
authors.forename: Geneviève
authors.initials: G
authors.lastname: Mulak
authors.forename: Michel
authors.initials: M
authors.lastname: Galinier
authors.forename: Pierre
authors.initials: P
authors.lastname: Gibelin
authors.forename: Hakim
authors.initials: H
authors.lastname: Benamer
authors.forename: Hélène
authors.initials: H
authors.lastname: Bouvaist
authors.forename: Nicolas
authors.initials: N
authors.lastname: Méneveau
authors.forename: Xavier
authors.initials: X
authors.lastname: Tabone
authors.forename: Tabassome
authors.initials: T
authors.lastname: Simon
authors.forename: Nicolas
authors.initials: N
authors.lastname: Danchin
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006333:Heart Failure / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D006334:Heart Function Tests; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality / Q000628:therapy; D015425:Myocardial Reperfusion; D012042:Registries; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D002317:Cardiovascular Agents; D003402:Creatine Kinase