A Long-Term Incidence of Heart Failure and Predictors Following Newly Developed Acute Myocardial Infarction: A 10 Years Retrospective Cohort Study with Korean National Health Insurance Data
Abstract: Background
1. Introduction
2. Methods
2.1. Data Sources and Study Subjects
2.2. Definition of First Episode of AMI and Baseline Cohort
2.3. Follow-Up and HF Occurrence
2.4. The Risk Factors on Late-Onset HF Post AMI
2.5. Statistical Analysis
3. Results
3.1. Incidence Rate of Newly Developed AMI
3.2. Cumulative Incidence Rates of HF and Case-Fatality Rate Among Newly Developed AMI during 6 Years Follow Up
3.3. The Impacts of Characteristics, Health Care Utilization and Medication in Index Hospitalization on Late Onset HF Incidence
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Age | Total | Men | Women | ||||||
---|---|---|---|---|---|---|---|---|---|
N | AMI | IR | N | AMI | IR | N | AMI | IR | |
40–49 | 8,715,639 | 2059 | (23.6) | 4,434,091 | 1921 | (43.3) | 4,281,548 | 138 | (3.2) |
50–59 | 6,726,716 | 3918 | (58.2) | 3,369,420 | 3432 | (101.9) | 3,357,296 | 486 | (14.5) |
60–69 | 4,092,725 | 4547 | (111.1) | 1,946,828 | 3299 | (169.5) | 2,145,897 | 1248 | (58.2) |
70–79 | 2,536,642 | 5066 | (199.7) | 1,027,907 | 2765 | (269.0) | 1,508,735 | 2301 | (152.5) |
80+ | 907,282 | 2738 | (301.8) | 261,387 | 986 | (377.2) | 645,895 | 1752 | (271.3) |
Total | 22,979,004 | 18,328 | (79.8) | 11,039,633 | 12,403 | (112.3) | 11,939,371 | 5925 | (49.6) |
Sex | Age | AMI | Heart Failure | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Index Hospitalization | Until 1 Year after Discharge | During 1–6 Years | Overall | |||||||
N | N | CIR | N | CIR | N | CIR | N | CIR | ||
Men | 40–49 | 1921 | 26 | 13.5 | 32 | 16.9 | 38 | 4.1 | 96 | 8.8 |
50–59 | 3432 | 62 | 18.1 | 55 | 16.3 | 76 | 4.6 | 193 | 9.9 | |
60–69 | 3299 | 82 | 24.9 | 61 | 19.0 | 114 | 7.2 | 257 | 14.1 | |
70–79 | 2765 | 112 | 40.5 | 92 | 34.7 | 149 | 11.6 | 353 | 24.4 | |
80+ | 986 | 71 | 72.0 | 46 | 50.3 | 57 | 13.1 | 174 | 35.7 | |
Total | 12,403 | 353 | 28.5 | 286 | 23.7 | 434 | 7.4 | 1073 | 15.8 | |
Women | 40–49 | 138 | 4 | 29.0 | 3 | 22.4 | 3 | 4.6 | 10 | 13.0 |
50–59 | 486 | 14 | 28.8 | 15 | 31.8 | 18 | 7.9 | 47 | 17.8 | |
60–69 | 1248 | 59 | 47.3 | 39 | 32.8 | 48 | 8.3 | 146 | 22.1 | |
70–79 | 2301 | 125 | 54.3 | 107 | 49.2 | 145 | 14.0 | 377 | 32.7 | |
80+ | 1752 | 130 | 74.2 | 119 | 73.4 | 108 | 14.4 | 357 | 42.7 | |
Total | 5925 | 332 | 56.0 | 283 | 50.6 | 322 | 12.1 | 937 | 31.3 | |
Total | 40–49 | 2059 | 30 | 14.6 | 35 | 17.2 | 41 | 4.1 | 106 | 9.0 |
50–59 | 3918 | 76 | 19.4 | 70 | 18.2 | 94 | 5.0 | 240 | 10.9 | |
60–69 | 4547 | 141 | 31.0 | 100 | 22.7 | 162 | 7.5 | 403 | 16.2 | |
70–79 | 5066 | 237 | 46.8 | 199 | 41.2 | 294 | 12.7 | 730 | 28.1 | |
80+ | 2738 | 201 | 73.4 | 165 | 65.0 | 165 | 13.9 | 531 | 40.1 | |
Total | 18,328 | 685 | 37.4 | 569 | 32.3 | 756 | 8.9 | 2010 | 20.5 |
Period | Death | Heart Failure | Total | |||
---|---|---|---|---|---|---|
No | Yes | |||||
N | N | CIR | N | CFR | ||
Index hospitalization | No | 16,211 | 559 | 33.3 | 16,770 | |
Yes | 1432 | 126 | 80.9 | 1558 | 85.0 | |
Total | 17,643 | 685 | 37.4 | 18,328 | ||
6 months after initial discharge | No | 15,067 | 298 | 19.4 | 15,365 | |
Yes | 765 | 81 | 95.7 | 846 | 52.2 | |
Total | 15,832 | 379 | 23.4 | 16,211 | ||
7–12 months after initial discharge | No | 14,558 | 175 | 11.9 | 14,733 | |
Yes | 328 | 15 | 43.7 | 343 | 22.8 | |
Total | 14,886 | 190 | 12.6 | 15,076 | ||
1–6 years after initial discharge | No | 11,625 | 463 | 38.3 | 12,088 | |
Yes | 2177 | 293 | 118.6 | 2470 | 33.9 | |
Total | 13,802 | 756 | 51.6 | 14,558 |
HR | 95% CI | p Value | |
---|---|---|---|
Demographic and clinical characteristics | |||
Sex | |||
Men (ref.) | |||
Women | 0.954 | (0.813–1.119) | 0.5603 |
Age (years) | 1.046 | (1.039–1.054) | <0.0001 |
Type of medical insurance | |||
Medical aid (ref.) | |||
NHI | 0.554 | (0.453–0.679) | <0.0001 |
Pre-existing conditions | |||
No diabetes (ref.) | |||
Diabetes | 1.126 | (0.968–1.310) | 0.1252 |
No hypertension (ref.) | |||
Hypertension | 1.242 | (1.041–1.482) | 0.0159 |
No dyslipidemia (ref.) | |||
Dyslipidemia | 0.873 | (0.744–1.026) | 0.0988 |
Type of AMI | |||
STEMI (ref.) | |||
NSTEMI | 1.074 | (0.846–1.363) | 0.5586 |
Unspecified | 1.109 | (0.932–1.318) | 0.2434 |
Severity | |||
Moderate (ref.) | |||
Severe | 2.487 | (2.105–2.938) | <0.0001 |
Health care utilization | |||
Hospital size | |||
Tertiary general hospital (ref.) | |||
General hospital | 0.998 | (0.860–1.157) | 0.9779 |
Hospital | 1.321 | (0.880–1.982) | 0.1789 |
Length of stay (days) | 1.001 | (1.000–1.002) | 0.0126 |
Reperfusion therapy | |||
No (ref.) | |||
Thrombolytics | 1.401 | (0.619–3.175) | 0.4187 |
PCI | 0.627 | (0.515–0.764) | <0.0001 |
CABG | 0.435 | (0.271–0.697) | 0.0005 |
Medication | |||
Number of drugs | |||
0 (reference) | |||
1–2 | 0.597 | (0.411–0.866) | 0.0065 |
3+ | 0.769 | (0.553–1.069) | 0.1181 |
Diuretic | |||
No (reference) | |||
Yes | 1.809 | (1.499–2.185) | <0.0001 |
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Choi, H.; Seo, J.Y.; Shin, J.; Choi, B.Y.; Kim, Y.-M. A Long-Term Incidence of Heart Failure and Predictors Following Newly Developed Acute Myocardial Infarction: A 10 Years Retrospective Cohort Study with Korean National Health Insurance Data. Int. J. Environ. Res. Public Health 2021, 18, 6207. https://doi.org/10.3390/ijerph18126207
Choi H, Seo JY, Shin J, Choi BY, Kim Y-M. A Long-Term Incidence of Heart Failure and Predictors Following Newly Developed Acute Myocardial Infarction: A 10 Years Retrospective Cohort Study with Korean National Health Insurance Data. International Journal of Environmental Research and Public Health. 2021; 18(12):6207. https://doi.org/10.3390/ijerph18126207
Chicago/Turabian StyleChoi, Hyojung, Joo Yeon Seo, Jinho Shin, Bo Youl Choi, and Yu-Mi Kim. 2021. "A Long-Term Incidence of Heart Failure and Predictors Following Newly Developed Acute Myocardial Infarction: A 10 Years Retrospective Cohort Study with Korean National Health Insurance Data" International Journal of Environmental Research and Public Health 18, no. 12: 6207. https://doi.org/10.3390/ijerph18126207