title: Prognostic Impact of In-Hospital and Postdischarge Heart Failure in Patients With Acute Myocardial Infarction: A Nationwide Analysis Using Data From the Cardiovascular Disease in Norway (CVDNOR) Project.
abstract: BACKGROUND
  Heart failure (HF) is a serious complication of acute myocardial infarction (AMI). We explored the excess mortality associated with HF as an early or late complication of AMI and describe changes over time in such excess mortality.
  
  
  RESULTS
  All patients hospitalized with an incident AMI and without history of prior HF hospitalization were followed up to 1 year after AMI discharge for episodes of HF. New HF episodes were classified asin-hospital HFif diagnosed during the AMI hospitalization orpostdischarge HFif diagnosed within 1 year after discharge from the incident AMI. Logistic and Cox regression models were used to explore the excess mortality associated with HF categories. Changes over time in the excess mortality were assessed by testing the interaction between HF status and study year. In-hospital HF increased in-hospital mortality 1.79 times (odds ratio [OR], 1.79; 95% CI: 1.68-1.91). The excess mortality associated with HF increased by 4.3 times from 2001 to 2009 (Pinteraction<0.001) as a consequence of a greater decline of in-hospital mortality among AMI patients without (9% per year) compared to those with in-hospital HF (3% per year). Postdischarge HF increased all-cause and CVD mortality 5.98 times (hazard ratio, 5.98; 95% CI: 5.39-6.64) and 7.93 times (subhazard ratio, 7.93; 95% CI: 6.84 -9.19), respectively. The relative excess 1-year mortality associated with HF did not change significantly over time.
  
  
  CONCLUSIONS
  Development of HF-either as an early or late complication of AMI-has a negative impact on patients' survival. Changes in the excess mortality associated with HF are driven by modest improvements in survival among AMI patients with HF as compared to those without HF.
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway gerhard.sulo@uib.no.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Sulo
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway.
authors.forename: Jannicke
authors.initials: J
authors.lastname: Igland
authors.affiliation: Department of Clinical Science, University of Bergen, Norway.|Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
authors.forename: Ottar
authors.initials: O
authors.lastname: Nygård
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway.|Centre for Burden of Disease, Norwegian Institute of Public Health, Bergen, Norway.
authors.forename: Stein Emil
authors.initials: SE
authors.lastname: Vollset
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway.|Domain for Health Data and Digitalization, Department of Health Registry Research, Norwegian Institute of Public Health, Bergen, Norway.
authors.forename: Marta
authors.initials: M
authors.lastname: Ebbing
authors.affiliation: International Centre for Circulatory Health and Imperial Clinical Trials Unit, National Heart and Lung Institute and School of Public Health, Imperial College, London, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Poulter
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway.|Domain for Health Data and Digitalization, Department of Health Registry Research, Norwegian Institute of Public Health, Bergen, Norway.
authors.forename: Grace M
authors.initials: GM
authors.lastname: Egeland
authors.affiliation: Research Centre for Prevention and Health, Capital Region, Copenhagen, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Cerqueira
authors.affiliation: Research Centre for Prevention and Health, Capital Region, Copenhagen, Denmark.|Department of Public Health, Institute of Clinical Science, University of Copenhagen, Denmark.|Faculty of Medicine, University of Aalborg, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Jørgensen
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway.|Domain for Health Data and Digitalization, Department of Health Registry Research, Norwegian Institute of Public Health, Bergen, Norway.
authors.forename: Grethe S
authors.initials: GS
authors.lastname: Tell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology* / Q000209:etiology; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000453:epidemiology / Q000601:surgery; D009204:Myocardial Revascularization; D009664:Norway / Q000453:epidemiology; D016017:Odds Ratio; D010351:Patient Discharge / Q000639:trends*; D011159:Population Surveillance / Q000379:methods*; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: 
  CVDNOR
  ; Norway; acute myocardial infarction; heart failure; mortality; trends