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Managed Care after Acute Myocardial Infarction (MC-AMI) improves prognosis in AMI survivors with pre-existing heart failure: A propensity score matching analysis of Polish nationwide program of comprehensive post-MI care. | LitMetric

AI Article Synopsis

  • Despite advancements in treating acute myocardial infarction (AMI), post-discharge death rates remain high, particularly in patients with heart failure (HF) post-MI, with only about half surviving four years.
  • The study analyzed the effects of managed care after AMI (MC-AMI) on survival rates in patients with existing HF, involving 7228 patients in Poland, with MC-AMI participants showing significantly lower mortality rates.
  • Results indicated that MC-AMI participation led to reduced strokes, fewer hospitalizations for HF, and overall better survival rates within the first year, establishing it as a key factor for improving outcomes in these patients.

Article Abstract

Background: Despite improvement in acute myocardial infarction (AMI) treatment, post-discharge mortality remains high. The outcomes are supposed to be even worse in patients with post-MI heart failure (HF), as only a half of patients with newly diagnosed HF survive four years.

Aims: The study aimed to analyze whether managed care after acute myocardial infarction (MC-AMI) is associated with better survival in AMI survivors with a pre-existing diagnosis of HF.

Results: The study included 7228 patients with a pre-existing diagnosis of HF who survived the hospitalization for AMI in Poland between November 2017 and December 2020, of whom 2268 (31.4%) were referred for the MC-AMI program. The median follow-up was 1.5 (0.7-2.3) years. In the unmatched analysis, patients without MC-AMI had more than twice higher 12-month mortality (21.8% vs. 9.9%; P <0.01) than MC-AMI participants. The difference remained significant after propensity score matching (16,8% vs. 10.0%; P <0.01). In multivariable analysis, participation in MC-AMI was an independent factor of 12-month survival. MC-AMI participants had a lower stroke rate (1.5% vs. 3.0%; P <0.01) and fewer hospital admissions due to HF (22.9% vs. 27.6%; P <0.01).

Conclusions: After propensity score matching, participation in MC-AMI was associated with lower rates of stroke, HF hospitalizations, and all-cause mortality in the 12-month follow-up and was an independent factor of 12-month survival in AMI survivors with pre-existing HF.

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Source
http://dx.doi.org/10.33963/KP.a2022.0029DOI Listing

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