Trends From 1996 to 2007 in Incidence and Mortality Outcomes of Heart Failure After Acute Myocardial Infarction: A Population‐Based Study of 20 812 Patients With First Acute Myocardial Infarction in Western Australia

<jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Advances in treatment for acute myocardial infarction ( <jats:styled-content style="fixed-case">AMI</jats:styled-content> ) are likely to have had a beneficial impact on the incidence of and deaths attributable to heart failure ( <jats:styled-content style="fixed-case">HF</jats:styled-content> ) complicating <jats:styled-content style="fixed-case">AMI</jats:styled-content> , although limited data are available to support this contention. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">W</jats:styled-content> estern <jats:styled-content style="fixed-case">A</jats:styled-content> ustralian linked administrative health data were used to identify 20 812 consecutive patients, aged 40 to 84 years, without prior <jats:styled-content style="fixed-case">HF</jats:styled-content> hospitalized with an index (first) <jats:styled-content style="fixed-case">AMI</jats:styled-content> between 1996 and 2007. We assessed the temporal incidence of and adjusted odds ratio/hazard ratio for death associated with <jats:styled-content style="fixed-case">HF</jats:styled-content> concurrent with <jats:styled-content style="fixed-case">AMI</jats:styled-content> admission and within 1 year after discharge. Concurrent <jats:styled-content style="fixed-case">HF</jats:styled-content> comprised 75% of incident <jats:styled-content style="fixed-case">HF</jats:styled-content> cases. Between the periods 1996–1998 and 2005–2007, the prevalence of <jats:styled-content style="fixed-case">HF</jats:styled-content> after <jats:styled-content style="fixed-case">AMI</jats:styled-content> declined from 28.1% to 16.5%, with an adjusted odds ratio of 0.50 (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> , 0.44 to 0.55). The crude 28‐day case‐fatality rate for patients with concurrent <jats:styled-content style="fixed-case">HF</jats:styled-content> declined marginally from 20.5% to 15.9% ( <jats:italic>P</jats:italic> <0.05) compared with those without concurrent <jats:styled-content style="fixed-case">HF</jats:styled-content> , in whom the case‐fatality rate declined from 11.0% to 4.8% ( <jats:italic>P</jats:italic> <0.001). Concurrent <jats:styled-content style="fixed-case">HF</jats:styled-content> was associated with a multivariate‐adjusted odds ratio of 2.2 for 28‐day mortality and a hazard ratio of 2.2 for 1‐year mortality in 28‐day survivors. Occurrence of <jats:styled-content style="fixed-case">HF</jats:styled-content> within 90 days of the index <jats:styled-content style="fixed-case">AMI</jats:styled-content> was associated with an adjusted hazard ratio of 2.7 for 1‐year mortality in 90‐day survivors. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> Despite encouraging declines in the incidence of <jats:styled-content style="fixed-case">HF</jats:styled-content> complicating <jats:styled-content style="fixed-case">AMI</jats:styled-content> , it remains a common problem with high mortality. Increased attention to these high‐risk patients is needed given the lack of improvement in their long‐term prognosis. </jats:p> </jats:sec>