Prognosis of Developing Heart Failure Following ST Elevation (STEMI) and Non ST Elevation (NSTEMI) Infarct

Abstract

Background: Patients with myocardial infarction (MI) and Heart failure (HF) have a poor prognosis. However, there is a paucity of data investigating the difference in the prognosis of patients who developed HF following either ST elevation (STEMI) or non-ST elevation MI (NSTEMI) as evidenced by electrocardiogram (ECG). Aim: To identify the prognosis of patients who develop HF following STEMI and NSTEMI. Method: Case notes of 204 patients who had an MI in 1998 were identified according to the hospital discharge summary by the Hull & East Yorkshire Hospitals Trust Information Department, were used to identify events between 1998 and 2005. Results: 40% had died by the end of 205. 68% of the sample were male (mean age 67 ±12 years). 71% of patients had STEMI and 29% had NSTEMI. The overall mortality was similar in STEMI and NSTEMI (41% vs 32%). However, there was a trend towards higher early mortality in STEMI during index admission (21% vs 11%). 81 patients developed HF following MI during the index admission. These patients had higher early (during first admission), late (during follow-up) and overall mortality rates when compared to those who did not develop heart failure Similar trends were observed in those with STEMI and NSTEMI. Patients with STEMI were at higher risk of developing HF during the first admission than those presenting with in NSTEMI. These patients had a similar overall mortality rate during the five-year follow-up. Patients with NSTEMI had higher late mortality compare to STEMI. Conclusion: Patients who develop heart failure following an MI have higher all cause mortality then those who do not develop heart failure. Patients presenting with STEMI and NSTEMI and develop HF have similar mortality over 5 years and hence require equally robust secondary prevention and heart failure management.