%0 Journal Article
%T Correlates and prognostic impact of new
%A Aaron Crowley
%A Ajay J Kirtane
%A Akiko Maehara
%A Bj£¿rn Redfors
%A C Michael Gibson
%A D Christopher Metzger
%A Dariusz Dudek
%A Gennaro Giustino
%A Gregg W Stone
%A Philippe G¨¦n¨¦reux
%A Roxana Mehran
%A Sorin J Brener
%A Thomas Neunteufl
%J European Heart Journal: Acute Cardiovascular Care
%@ 2048-8734
%D 2018
%R 10.1177/2048872617719649
%X The determinants and significance of early (30-day) heart failure symptoms after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI) remain unclear. We investigated the clinical and imaging correlates of early post-discharge heart failure in patients with STEMI, and evaluated its impact on clinical outcomes. Patients from the INFUSE-AMI trial were categorized according to New York Heart Association (NYHA) functional classification at their 30-day visit (NYHA class ¡Ý2 versus 1). Independent correlates of NYHA class ¡Ý2 were determined by multivariable logistic regression. A landmark analysis beyond 30 days was performed to assess the impact of 30-day NYHA class ¡Ý2 on 1-year risk of death or hospitalization for heart failure. Among 402 patients enrolled in the INFUSE-AMI trial with data on NYHA class at 30 days, 76 (18.9%) had NYHA class ¡Ý2. Independent correlates of 30-day NYHA class ¡Ý2 were age, Killip class ¡Ý2 at presentation, heart rate at presentation, intraprocedural no-reflow, and 30-day infarct size (% total ventricular mass). After adjustment for infarct size, patients with NYHA class ¡Ý2 remained at higher risk of death or hospitalization for heart failure at 1-year follow-up compared to those in NYHA class 1 (11.8% vs. 2.8%, adjusted hazard ratio 3.78, 95% confidence interval 1.16¨C12.22, P=0.03). Clinical, procedural, and imaging variables predict the development of clinical heart failure after primary percutaneous coronary intervention in patients with STEMI. Early post-discharge heart failure symptoms identify a high-risk patient cohort for subsequent heart failure hospitalization and death, independent of infarct size. ClinicalTrials.gov; NCT0097652
%K ST-segment elevation myocardial infarction
%K New York Heart Association
%K heart failure
%K infarct size
%K magnetic resonance imaging
%U https://journals.sagepub.com/doi/full/10.1177/2048872617719649