title: Trends in mortality and heart failure after acute myocardial infarction in Italy from 2001 to 2011.
abstract: BACKGROUND
  Uncertainties on long-term outcomes after acute myocardial infarction (AMI) still exist, despite the ongoing progresses in the management of patients with AMI.
  
  
  OBJECTIVE
  Our aim was to appraise both the early prognosis and prognosis at 1-year after discharge of patients hospitalized due to AMI.
  
  
  METHODS
  This is a retrospective nationwide cohort study based on data from an administrative database on patients admitted with AMI from 2001 to 2011 in all Italian hospitals sites. Mortality and readmission rates within 30 days, 60 days and 1 year were calculated, as well as re-hospitalizations for all causes and for HF.
  
  
  RESULTS
  A total of 1,110,822 patients were included. Index admission mortality rate (I-MR) and total in-hospital mortality rate (T-MR) at up to 1 year both decreased respectively from 11.34% to 8.99% and from 16.46% to 14.68% in the years 2001 to 2011 (both p<0.0001), while fatal readmission rate (F-RR) at 1 year increased from 4.75% to 5.28% (p=0.0019). Patients that developed HF during the index admission had significantly higher I-MR and F-RR. I-MR, F-RR, and T-MR, however, remained low at any time point considered (30 days, 60 days and 1 year) in a subgroup of low-risk optimally-treated patients.
  
  
  CONCLUSIONS
  The risk of fatal readmission at 1 year increased slightly over time, in spite of the remarkable improvements currently achieved in overall prognosis after AMI. The identification of patients at high risk (mainly due to HF complicating AMI), and of patients at low risk is crucial to define and support management strategies.
authors.affiliation: Division of Cardiology, San Giovanni Hospital, Rome, Italy. Electronic address: cgreco@hsangiovanni.roma.it.
authors.forename: Cesare
authors.initials: C
authors.lastname: Greco
authors.affiliation: Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Rosato
authors.affiliation: Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: D'Errigo
authors.affiliation: Division of Cardiology, San Giovanni Hospital, Rome, Italy.
authors.forename: Gian Francesco
authors.initials: GF
authors.lastname: Mureddu
authors.affiliation: Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Lacorte
authors.affiliation: Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Fulvia
authors.initials: F
authors.lastname: Seccareccia
mesh_terms: D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality*; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009026:Mortality / Q000639:trends; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality*; D012042:Registries; D012189:Retrospective Studies
keywords: Acute coronary syndromes; Acute myocardial infarction; Discharge; Heart failure; Mortality; Trend