An electronic health records cohort study on heart failure following myocardial infarction in England: incidence and predictors

Gho, J. M.I.H. et al. (2018) An electronic health records cohort study on heart failure following myocardial infarction in England: incidence and predictors. BMJ Open, 8(3), e018331. (doi: 10.1136/bmjopen-2017-018331) (PMID:29502083)

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Abstract

Objectives: To investigate the incidence and determinants of heart failure (HF) following a myocardial infarction (MI) in a contemporary cohort of patients with MI using routinely collected primary and hospital care electronic health records (EHRs). Methods: Data were used from the CALIBER programme, linking EHRs in England from primary care, hospital admissions, an MI registry and mortality data. Subjects were eligible if they were 18 years or older, did not have a history of HF and survived a first MI. Factors associated with time to HF were examined using Cox proportional hazard models. Results: Of the 24 479 patients with MI, 5775 (23.6%) developed HF during a median follow-up of 3.7 years (incidence rate per 1000 person-years: 63.8, 95% CI 62.2 to 65.5). Baseline characteristics significantly associated with developing HF were: atrial fibrillation (HR 1.62, 95% CI 1.51 to 1.75), age (per 10 years increase: 1.45, 1.41 to 1.49), diabetes (1.45, 1.35 to 1.56), peripheral arterial disease (1.38, 1.26 to 1.51), chronic obstructive pulmonary disease (1.28, 1.17 to 1.40), greater socioeconomic deprivation (5th vs 1st quintile: 1.27, 1.13 to 1.41), ST-segment elevation MI at presentation (1.19, 1.11 to 1.27) and hypertension (1.16, 1.09 to 1.23). Results were robust to various sensitivity analyses such as competing risk analysis and multiple imputation. Conclusion: In England, one in four survivors of a first MI develop HF within 4 years. This contemporary study demonstrates that patients with MI are at considerable risk of HF. Baseline patient characteristics associated with time until HF were identified, which may be used to target preventive strategies.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Gho, J. M.I.H., Schmidt, A. F., Pasea, L., Koudstaal, S., Pujades-Rodriguez, M., Denaxas, S., Shah, A. D., Patel, R. S., Gale, C. P., Hoes, A. W., Cleland, J. G., Hemingway, H., and Asselbergs, F. W.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Published Online:03 March 2018
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in BMJ Open 8(3): e018331
Publisher Policy:Reproduced under a Creative Commons License

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