Study Links CAD to Heart Failure After Myocardial Infarction
A strong connection exists between coronary artery disease (CAD) and heart failure (HF) after myocardial infarction (MI), according to a new study.
Investigators sought to evaluate the association of angiographic CAD with subsequent HF in a community cohort of patients with incident MI, and to examine the prognostic role of CAD according to HF subtypes: HF with reduced ejection fraction and HF with preserved ejection fraction.
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To do so, the researchers conducted a population-based cohort study of 1922 residents of Olmstead County, Minnesota, with incident MI diagnosed between January 1, 1990 and December 31, 2010, and no prior HF. Of the participants, 1258 were men. Study participants were followed up through March 31, 2013, with the authors determining the extent of angiographic CAD at baseline, and categorizing the extent of angiographic CAD based on the number of major epicardial coronary arteries with 50% or more lumen diameter obstruction.
Over the mean follow-up period of 6.7 years, 588 patients (30.6%) developed HF. Compared with patients with 0 or 1 blocked arteries, those with 2 blocked arteries were found to be at much greater risk of HF. Patients with 3 blocked arteries were at even higher risk, according to the authors, who note that this increased risk was independent of recurrent MI, and “did not differ appreciably” with HF subtypes.
Ultimately, “the extent of angiographic coronary artery disease is an indicator of post-MI HF regardless of HF type and independent of recurrent myocardial infarction,” the researchers wrote, adding that “these data underscore the need to further investigate the processes taking place in the transition from myocardial infarction to HF.”
—Mark McGraw
Reference:
Gerber Y, Weston S, Enriquez-Sarano M, et al. atherosclerotic burden and heart failure after myocardial infarction [published online March 30, 2016]. JAMA Cardiol. doi:10.1001/jamacardio.2016.0074