TY - JOUR
T1 - Impact of a ‘stent for life’ initiative on post-ST elevation myocardial infarction heart failure: a 15 year heart failure clinic experience
AU - Bayes-Genis, Antoni
AU - García, Cosme
AU - de Antonio, Marta
AU - Fernandez-Nofrerías, Eduard
AU - Domingo, Mar
AU - Zamora, Elisabet
AU - Moliner, Pedro
AU - Lupón, Josep
PY - 2018/1/1
Y1 - 2018/1/1
N2 - © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. Aims: Multidisciplinary heart failure (HF) clinics are a cornerstone of contemporary HF management. The stent-for-life (SFL) initiative improves mortality after ST elevation myocardial infarction (STEMI), but its impact in post-STEMI HF is not well characterized. Here we assessed the impact of SFL among patients referred to a multidisciplinary HF clinic over a 15 year time period. Methods and results: Between 2001 and 2015, 1921 patients were admitted to our HF clinic. In 2009, Catalonia established the Codi IAM network, a regional STEMI network that prioritizes primary percutaneous coronary intervention in STEMI. Patients admitted during the study period were divided into two groups based on admission date: pre-SFL (2001–June 2009; n = 1031) and post-SFL (July 2009–2015; n = 890). Compared with those in the pre-SFL group, patients admitted in the post-SFL period had better New York Heart Association (NYHA) functional class (22.1 vs. 38.7 NYHA classes III–IV; P < 0.001) and higher left ventricular ejection fraction (LVEF) (36.1 ± 19.6 vs. 32.6 ± 13.4; P < 0.001). Among STEMI survivors, 101 (6.7%) pre-SFL patients and 40 (2%) post-SFL patients (P < 0.001) fulfilled the criteria for HF clinic referral (Killip–Kimball class ≥ 2 during index admission and/or LVEF of <40%). Furthermore, among patients admitted to the HF clinic, post-STEMI HF with reduced ejection fraction patients comprised 8.9% of the pre-SFL group and only 4.2% of the post-SFL group (P < 0.001). Conclusions: Among patients treated at our multidisciplinary HF clinic, the adoption of an SFL network has decreased the prevalence of post-STEMI HF with reduced ejection fraction.
AB - © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. Aims: Multidisciplinary heart failure (HF) clinics are a cornerstone of contemporary HF management. The stent-for-life (SFL) initiative improves mortality after ST elevation myocardial infarction (STEMI), but its impact in post-STEMI HF is not well characterized. Here we assessed the impact of SFL among patients referred to a multidisciplinary HF clinic over a 15 year time period. Methods and results: Between 2001 and 2015, 1921 patients were admitted to our HF clinic. In 2009, Catalonia established the Codi IAM network, a regional STEMI network that prioritizes primary percutaneous coronary intervention in STEMI. Patients admitted during the study period were divided into two groups based on admission date: pre-SFL (2001–June 2009; n = 1031) and post-SFL (July 2009–2015; n = 890). Compared with those in the pre-SFL group, patients admitted in the post-SFL period had better New York Heart Association (NYHA) functional class (22.1 vs. 38.7 NYHA classes III–IV; P < 0.001) and higher left ventricular ejection fraction (LVEF) (36.1 ± 19.6 vs. 32.6 ± 13.4; P < 0.001). Among STEMI survivors, 101 (6.7%) pre-SFL patients and 40 (2%) post-SFL patients (P < 0.001) fulfilled the criteria for HF clinic referral (Killip–Kimball class ≥ 2 during index admission and/or LVEF of <40%). Furthermore, among patients admitted to the HF clinic, post-STEMI HF with reduced ejection fraction patients comprised 8.9% of the pre-SFL group and only 4.2% of the post-SFL group (P < 0.001). Conclusions: Among patients treated at our multidisciplinary HF clinic, the adoption of an SFL network has decreased the prevalence of post-STEMI HF with reduced ejection fraction.
KW - HF with reduced ejection fraction
KW - Heart failure clinics
KW - Left ventricular ejection fraction
KW - New York Heart Association
KW - ST elevation myocardial infarction
KW - Stent for life
U2 - https://doi.org/10.1002/ehf2.12245
DO - https://doi.org/10.1002/ehf2.12245
M3 - Article
C2 - 29285897
VL - 5
SP - 101
EP - 105
JO - ESC heart failure
JF - ESC heart failure
SN - 2055-5822
IS - 1
ER -