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

Title: An electronic health records cohort study on heart failure following myocardial infarction in England: incidence and predictors.
Author(s): Gho, JMIH
Schmidt, AF
Pasea, L
Koudstaal, S
Pujades-Rodriguez, M
Denaxas, S
Shah, AD
Patel, RS
Gale, CP
Hoes, AW
Cleland, JG
Hemingway, H
Asselbergs, FW
Item Type: Journal Article
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.
Publication Date: 3-Mar-2018
Date of Acceptance: 12-Jan-2018
URI: http://hdl.handle.net/10044/1/59816
DOI: https://dx.doi.org/10.1136/bmjopen-2017-018331
ISSN: 2044-6055
Publisher: BMJ Journals
Journal / Book Title: BMJ Open
Volume: 8
Issue: 3
Copyright Statement: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Keywords: electronic health records
heart failure
myocardial infarction
electronic health records
heart failure
myocardial infarction
Publication Status: Published
Conference Place: England
Article Number: e018331
Online Publication Date: 2018-03-03
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine



Items in Spiral are protected by copyright, with all rights reserved, unless otherwise indicated.

Creative Commons