This study was supported in part by grants from the Medical Council of the Finnish Academy of Science, and the Sigrid Juselius Foundation, Helsinki, Finland.
Predictors of Long-Term Risk for Heart Failure Hospitalization after Acute Myocardial Infarction
Article first published online: 13 JUL 2010
©2010, Wiley Periodicals, Inc.
Annals of Noninvasive Electrocardiology
Volume 15, Issue 3, pages 250–258, July 2010
How to Cite
Perkiömäki, J. S., Hämekoski, S., Junttila, M. J., Jokinen, V., Tapanainen, J. and Huikuri, H. V. (2010), Predictors of Long-Term Risk for Heart Failure Hospitalization after Acute Myocardial Infarction. Annals of Noninvasive Electrocardiology, 15: 250–258. doi: 10.1111/j.1542-474X.2010.00372.x
- Issue published online: 13 JUL 2010
- Article first published online: 13 JUL 2010
- myocardial infarction;
- heart failure;
- brain natriuretic peptide;
- heart rate variability;
- heart rate turbulence;
- baroreflex sensitivity
Background: Data on the value of baseline brain natriuretic peptide (BNP) and autonomic markers in predicting heart failure (HF) hospitalization after an acute myocardial infarction (AMI) are limited.
Methods: A consecutive series of patients with AMI without a previous history of HF (n = 569) were followed up for 8 years. At baseline, the patients had a blood sample for determination of BNP, a 24-hour Holter recording for evaluating heart rate variability (HRV) and heart rate turbulence (HRT), and an assessment of baroreflex sensitivity (BRS) using phenylephrine test.
Results: During the follow-up, 79 (14%) patients were hospitalized due to HF. Increased baseline BNP, decreased HRV, HRT, and BRS had a significant association with HF hospitalization in univariate comparisons (P < 0.001 for all). After adjusting with all the relevant clinical parameters, BNP, HRV, and HRT still significantly predicted HF hospitalization (P < 0.001 for BNP and for the short-term scaling exponent α1, P < 0.01 for turbulence slope). In the receiver operator characteristics curve analysis, the area under the curve for BNP was 0.77, for the short-term scaling exponent α1 0.69, for turbulence slope 0.71, and for BNP/standard deviation of all N-N intervals ratio 0.80.
Conclusion: Baseline increased BNP and impaired autonomic function after AMI yield significant information on the long-term risk for HF hospitalization.
Ann Noninvasive Electrocardiol 2010;15(3):250–258