title: Nationwide trends in development of heart failure and mortality after first-time myocardial infarction 1997-2010: A Danish cohort study.
abstract: OBJECTIVE
  Pharmacological and revascularization strategies following myocardial infarction (MI) have changed substantially during the last two decades. We investigated the temporal trends in heart failure (HF) incidence and mortality during the first 90 days following first-time MI between 1997 and 2010 in Denmark.
  
  
  RESULTS
  Through administrative nationwide registers we identified 89,389 patients without prior HF hospitalized with first MI. The number of patients treated with percutaneous coronary intervention (PCI) days 0-1 after index MI increased from 2.5% in 1997-98 to 38.2% in 2009-10. Treatment with clopidogrel increased from 0.02% in 1997-98 to 68.1% in 2009-10 and statins from 8.1% in 1997-98 to 78.3% in 2009-10. The incidence of HF (defined as HF diagnosis or incident use of loop diuretics) decreased from 23.6% in 1997-98 to 19.6% in 2009-10 (p<0.001). Adjusted for age, sex, and comorbidity, hazard ratio was 0.77 (95% confidence interval [CI] 0.74-0.79) for developing HF in 2009-10, compared with 1997-98. Adjusted for coronary interventions, and pharmacotherapy HR increased to 0.82 (95% confidence interval (CI) 0.79-0.85) compared with 1997-98. The 90-day mortality decreased from 19.6% in 1997-98 to 11.7% in 2009-10 (p<0.001). Adjusted for age, sex, and comorbidity HR was 0.59 (CI 0.55-0.64) in 2009-10 compared with 1997-98; upon additional adjustment for coronary interventions and pharmacotherapy the estimate was 0.75 (95% CI 0.69-0.81).
  
  
  CONCLUSIONS
  We found a temporal decrease in HF incidence and mortality during the first 90 days after MI in 1997-2010. This could partly be explained by changes in interventional and pharmacological treatment strategies.
authors.affiliation: Department of Cardiology, Niels Andersens Vej 65, Gentofte University Hospital, 2900 Hellerup, Denmark. Electronic address: anne@gjesing.com.
authors.forename: Anne
authors.initials: A
authors.lastname: Gjesing
authors.affiliation: Department of Cardiology, Niels Andersens Vej 65, Gentofte University Hospital, 2900 Hellerup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen N, Denmark; National Institute of Public Health, University of Southern, Øster Farimagsgade 5 A, 1353 Copenhagen K, Denmark.
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Gislason
authors.affiliation: Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen N, Denmark; Department of Cardiology, The Heart Centre, Rigshospitalet, Blegdamsvej 9, Copenhagen University Hospital, 2100 Copenhagen Ø, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.affiliation: Department of Cardiology, Lund University, Paradisgatan 2, 221 00 Lund, Sweden; Department of Heart Failure and Valvular Disease, Skåne University Hospital, Paradisgatan 2, 221 00 Lund, Sweden; Department of Clinical Sciences, Clinical Research Centre, Skåne University Hospital, Jan Waldenströms Gata 35, Malmö, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Gustav Smith
authors.affiliation: Department of Cardiology, Niels Andersens Vej 65, Gentofte University Hospital, 2900 Hellerup, Denmark.
authors.forename: Stefan Bisgaard
authors.initials: SB
authors.lastname: Christensen
authors.affiliation: Department of Cardiology, The Heart Centre, Rigshospitalet, Blegdamsvej 9, Copenhagen University Hospital, 2100 Copenhagen Ø, Denmark.
authors.forename: Finn
authors.initials: F
authors.lastname: Gustafsson
authors.affiliation: Department of Cardiology, Niels Andersens Vej 65, Gentofte University Hospital, 2900 Hellerup, Denmark.
authors.forename: Anne-Marie Schjerning
authors.initials: AM
authors.lastname: Olsen
authors.affiliation: Institute of Health, Science and Technology, Aalborg University, Fredrik Bajers Vej 7D2, 9220 Aalborg, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.affiliation: Department of Cardiology, Niels Andersens Vej 65, Gentofte University Hospital, 2900 Hellerup, Denmark; Department of Clinical Sciences, Clinical Research Centre, Skåne University Hospital, Jan Waldenströms Gata 35, Malmö, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Andersson
mesh_terms: D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000628:therapy; D062645:Percutaneous Coronary Intervention / Q000706:statistics & numerical data; D011379:Prognosis
keywords: Epidemiology; Heart failure; Mortality; Myocardial infarction