PMID- 21982658
OWN - NLM
STAT- MEDLINE
DCOM- 20111123
LR  - 20220408
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 162
IP  - 4
DP  - 2011 Oct
TI  - Incidence and predictors of heart failure following percutaneous coronary 
      intervention in ST-segment elevation myocardial infarction: the HORIZONS-AMI 
      trial.
PG  - 663-70
LID - 10.1016/j.ahj.2011.08.002 [doi]
AB  - BACKGROUND: Congestive heart failure (CHF) is a major source of morbidity, 
      mortality, and health-care resource consumption. However, the incidence of 
      symptomatic CHF after primary percutaneous coronary intervention (PCI) for 
      ST-segment elevation myocardial infarction (STEMI) has rarely been fully 
      reported. We therefore examined the early and late incidence, predictors, and 
      implications of CHF in the large-scale, prospective, randomized HORIZONS-AMI 
      trial. METHODS AND RESULTS: New York Heart Association (NYHA) functional 
      classification was prospectively collected from patient-level data at baseline, 
      30 days, 6 months, and at 1 and 2 years from 3,343 patients with STEMI undergoing 
      PCI at 123 centers in 11 countries. The baseline incidence of CHF (before the 
      index STEMI) was 2.6%, increasing to 4.6% 1 month after primary PCI (P < .0001), 
      4.7% at 1 year, and 5.1% at 2 years. The incidence of NYHA class III/IV symptoms 
      was 0.4% at baseline and 0.8% at 2 years (P = .03). CHF at 1 year was associated 
      with diabetes (P < .0001), dyslipidemia (P = .009), previous MI (P < .0001), 
      previous revascularization (P = .01), anterior STEMI (P = .02), and baseline TIMI 
      grade 0 flow (P = .01) but not procedural anticoagulation with bivalirudin versus 
      heparin + GPIIb/IIIa inhibitors (P = .93) or use of drug-eluting versus bare 
      metal stents (P = .66). Among patients in whom CHF was not present at baseline 
      but developed after PCI, the rate of all-cause mortality was significantly higher 
      during 2-year follow-up (7.3% vs 2.0%, P < .0001), as was cardiac mortality (2.4% 
      vs 0.8%, P = .004), reinfarction (9.4% vs 5.2%, P = .0009), stent thrombosis 
      (7.0% vs 3.8%, P = .007), and ischemic target vessel revascularization (19.4% vs 
      11.8%, P < .0001). CONCLUSION: In the HORIZONS-AMI trial, the development of 
      new-onset CHF within 2 years after contemporary PCI, although infrequent, was 
      associated with significantly increased rates of mortality and major adverse 
      ischemic events.
CI  - Copyright (c) 2011 Mosby, Inc. All rights reserved.
FAU - Kelly, Damian J
AU  - Kelly DJ
AD  - Department of Academic Cardiology, Glenfield Hospital, Leicester, United Kingdom.
FAU - Gershlick, Tony
AU  - Gershlick T
FAU - Witzenbichler, Bernhard
AU  - Witzenbichler B
FAU - Guagliumi, Giulio
AU  - Guagliumi G
FAU - Fahy, Martin
AU  - Fahy M
FAU - Dangas, George
AU  - Dangas G
FAU - Mehran, Roxana
AU  - Mehran R
FAU - Stone, Gregg W
AU  - Stone GW
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary
MH  - Female
MH  - Heart Failure/*epidemiology/etiology
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/complications/physiopathology/*surgery
MH  - Prospective Studies
EDAT- 2011/10/11 06:00
MHDA- 2011/12/13 00:00
CRDT- 2011/10/11 06:00
PHST- 2011/05/03 00:00 [received]
PHST- 2011/08/03 00:00 [accepted]
PHST- 2011/10/11 06:00 [entrez]
PHST- 2011/10/11 06:00 [pubmed]
PHST- 2011/12/13 00:00 [medline]
AID - S0002-8703(11)00573-4 [pii]
AID - 10.1016/j.ahj.2011.08.002 [doi]
PST - ppublish
SO  - Am Heart J. 2011 Oct;162(4):663-70. doi: 10.1016/j.ahj.2011.08.002.