Abstract 9820: Heart Failure at Admission in Patients With ST-Elevation Myocardial Infarction. Registry ARGEN-IAM-ST

Abstract

Introduction: Heart failure (HF) is a frequent complication of ST-elevation myocardial infarction (STEMI). Despite advances in the management of STEMI, when associated with HF, its prognosis continues to be ominous. Knowing the reality and the management of these patients is a necessity that will guide us for future strategies. Objective: To evaluate incidence, associated factors, relationship with reperfusion strategies, treatment at admission, and evolution of patients (pts) with STEMI who present HF at admission. Material and Method: Data from the National Registry of ST-Elevation Myocardial Infarction of Argentina (ARGEN-IAM-ST) were analyzed from 1/1/2016 to 9/30/2020. Based on Killip and Kimball variable at admission, the population was divided into 2 groups, those pts with Killip and Kimball equal to 1 were grouped as pts without HF (noHF) at admission and those with Killip and Kimball greater to 1 as with HF at admission. Demographic characteristics, clinical, electrocardiographic, laboratory variables, and admission treatment were compared. Hospital mortality was compared. Results: 3,174 pts were analyzed. Pts with HF were 22.31%. Mean age (noHF vs HF) was 59.80 years (SD±11.45) and 64.01 years (SD±12.14), p<0.0001; predominance of women in HF (24.50% vs 18.50%, p<0.001). The baselines characteristics can be seen in Table 1. Reperfusion strategy was less used in HF group [87.57% vs 92.58%, OR 0.56 (95%CI 0.43-0.74), p<0.001] and its success was less frequent (Table 2). Pharmacological treatment is shown in Figures 1 and 2. Mortality was 3.00% in noHF vs 28.39% in HF, p<0.001. In the multivariate analysis, the variables associated with changes in mortality are described in Table 3; HF was associated with an increase in mortality. Conclusions: Pts with STEMI associated with HF at admission are a different group with a higher risk. The reperfusion strategy and certain pharmacological treatments on admission are less frequent in these pts.