Epidemiol Health.  2016;38:e2016019. 10.4178/epih.e2016019.

Risk factors for heart failure in a cohort of patients with newly diagnosed myocardial infarction: a matched, case-control study in Iran

• Ahmadi A
• Etemad K
• Khaledifar A

• KMID: 2380705
• DOI: http://doi.org/10.4178/epih.e2016019

Abstract

OBJECTIVES
Risk factors for heart failure (HF) have not yet been studied in myocardial infarction (MI) patients in Iran. This study was conducted to determine these risk factors.
METHODS
In this nationwide, hospital-based, case-control study, the participants were all new MI patients hospitalized from April 2012 to March 2013 in Iran. The data on 1,691 new cases with HF (enrolled by census sampling) were compared with the data of 6,764 patients without HF as controls. We randomly selected four controls per one case, matched on the date at MI and HF diagnosis, according to incidence density sampling. Using conditional logistic regression models, odds ratios (ORs) with a 95% confidence interval (CI) were calculated to identify potential risk factors.
RESULTS
The one-year in-hospital mortality rate was 18.2% in the cases and higher than in the controls (12.1%) (p<0.05). Significant risk factors for HF were: right bundle branch block (RBBB) (OR, 2.86; 95% CI, 1.95 to 4.19), stroke (OR, 2.00; 95% CI, 1.39 to 2.89), and coronary artery bypass grafting (CABG) (OR, 2.03; 95% CI, 1.34 to 3.09). Diabetes, hypertension, percutaneous coronary intervention (PCI), atrial fibrillation, ventricular tachycardia, and age were determined to be the factors significantly associated with HF incidence (p<0.05). The most important factor in women was diabetes (OR, 1.41; 95% CI, 1.05 to 1.88). Age, hypertension, PCI, CABG, and RBBB were the most important factors in men.
CONCLUSIONS
Our findings may help to better identify and monitor the predictive risk factors for HF in MI patients. The pattern of risk factors was different in men and women.

Keyword

Heart failure; Epidemiology; Myocardial infarction; Mortality; Risk factors; Case-control studies

MeSH Terms

Atrial Fibrillation
Bundle-Branch Block
Case-Control Studies*
Censuses
Cohort Studies*
Coronary Artery Bypass
Diagnosis
Epidemiology
Female
Heart Failure*
Heart*
Hospital Mortality
Humans
Hypertension
Incidence
Iran*
Logistic Models
Male
Mortality
Myocardial Infarction*
Odds Ratio
Percutaneous Coronary Intervention
Risk Factors*
Stroke
Tachycardia, Ventricular