Decreasing trends in the incidence of heart failure after acute myocardial infarction from 1993-2004: a study of 175,216 patients with a first acute myocardial infarction in Sweden

Eur J Heart Fail. 2011 Feb;13(2):135-41. doi: 10.1093/eurjhf/hfq205. Epub 2010 Nov 30.


Aims: To investigate temporal trends in the risk of heart failure (HF) complicating acute myocardial infarction (AMI) and to determine whether these trends differ by gender or age.

Methods and results: The national Swedish hospital discharge and death registries from 1993 to 2004 were used to calculate age- and gender-specific trends for a first episode of HF within 3 years in 175 216 patients aged 35-84 and hospitalized with a first AMI. Overall, 14.4% of patients aged 35-64 and 31.5% of those aged 65-84 with AMI in 1993-1995 had a hospital diagnosis of HF within 3 years (including the index admission). Corresponding figures for patients with AMI from 2002 to 2004 were 11.5 and 28.0%, respectively. In multivariable analyses, the risk of HF decreased by 4% per year. Having had a stroke before admission increased HF risk by 37%, diabetes increased the risk by 76% and atrial fibrillation by 80%. Patients with any kind of valvular disease had a more than doubled risk. Women had a 6% higher incidence of HF than men, whereas men with an index admission for AMI who did not develop HF had higher mortality than women.

Conclusions: In this national sample, we observed a steady decrease in the risk of being hospitalized with HF after an AMI. However, the 3-year risk of HF remains high, with nearly one-third of AMI patients aged 65-84 developing HF within 3 years.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / epidemiology*
  • Heart Failure / etiology
  • Hospital Mortality / trends*
  • Hospitalization / statistics & numerical data
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / complications
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / epidemiology*
  • Prognosis
  • Registries
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution
  • Stroke / complications
  • Stroke / diagnosis
  • Stroke / epidemiology*
  • Survival Analysis
  • Sweden / epidemiology