The impact of heart failure on clinical and economic outcomes among older adults with acute myocardial infarction

By Samar Mahmoud, MS
Published February 1, 2022

Key Takeaways

  • This large population-based study found that acute myocardial infarction (AMI) patients ≥ 75 years of age, but not patients ≥ 85 years of age, with heart failure (HF) were at greater risk of death than patients without HF. 

  • HF was associated with longer hospital stays and greater likelihood of referral to hospice and rehabilitation facilities. 

  • Strategies to identify HF in older adults during hospitalization for AMI are needed to enhance health outcomes.

HF after an AMI is a major contributor to cardiovascular mortality.

Why This Study Matters

The incidence of HF among AMI patients in different age groups is poorly described in the literature. This study sought to fill the gap by determining the impact of HF on clinical and economic outcomes, including healthcare utilization and cost, among older adults during AMI admission.

Study Design

The study included 468,654 patients admitted for AMI between January 1, 2000 and December 31, 2016. Investigators identified AMI admission using the primary diagnosis and incidence of HF using any secondary diagnosis. Outcomes of the study included overall mortality as well as length of hospital stay. 

Results and Conclusions

HF was common among AMI patients, with 42,946 (9%) study participants diagnosed with HF during their AMI admission. The overall mortality rate for patients with HF was 12%, the median hospital length of stay was 5 days, and only a quarter of patients were discharged home. 

A larger proportion of patients were discharged to rehabilitation or hospice if they had AMI and HF compared to AMI alone. The average adjusted cost of an AMI hospitalization increased by $1075 for patients with HF in comparison to AMI patients without HF. 

Related Research

Consider these findings from similar research studies:

  • Incidence of heart failure after myocardial infarction is linked to adverse events and lower rates of survival (Source). 

  • In older patients hospitalized for heart failure, implementing an early rehabilitation strategy led to greater improvements in physical function than traditional care (Source).

Original Source 

Pasala S, Cooper LB, Psotka MA, et al. The influence of heart failure on clinical and economic outcomes among older adults ≥75 years of age with acute myocardial infarction. American Heart Journal. 2022;246:65-73.

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