Post-myocardial infarction heart failure with reduced ejection fraction in older patients: a prospective multicentre study in Vietnam

Abstract

Abstract Background Heart failure (HF) is a common complication of myocardial infarction (MI) in older adults. However, data on the incidence of and risk factors for post-MI HF with reduced ejection fraction (HFrEF) are limited, especially among older Asian populations. Therefore, in this study, we aimed to determine the incidence of and risk factors for post-MI HFrEF in older Vietnamese patients with MI. Methods This prospective multicentre study enrolled 234 patients aged ≥ 60 years hospitalised for MI without prior HF at two tertiary hospitals in Vietnam. Data on demographics, MI details, treatments, and echocardiographic left ventricular ejection fraction (LVEF) during hospitalisation were collected. Post-MI HFrEF was defined as the diagnosis of HFrEF according to European Society of Cardiology guideline criteria at follow-up 3 months post-discharge. Multivariate logistic regression analysis identified the factors associated with post-MI HFrEF. Results Thirty patients (12.8%) developed post-MI HFrEF. Notably, most patients (94%) underwent coronary angiography, whereas 92% underwent revascularisation during the index hospitalisation. Independent predictors were female sex (odds ratio [OR]: 4.09, 95% confidence interval [CI]: 1.43–12.89), highest troponin T levels (OR: 1.15 per 1000 ng/L increase, 95% CI: 1.03–1.30), and reduced LVEF at discharge (OR: 6.88, 95% CI: 2.37–22.06). Conclusions In this study, with a high rate of coronary revascularisation, the incidence of post-MI HFrEF was 12.8% at 3 months. Female sex, larger infarct size reflected by higher peak troponin T levels, and lower pre-discharge LVEF were associated with increased HFrEF risk. These findings can guide post-MI monitoring and early therapy in high-risk individuals to optimise outcomes.