Abstract 18289: A Real-World Analysis Of New-Onset Heart Failure After Anterior Wall ST-Elevation Acute Myocardial Infarction

Introduction: The one-year incidence of heart failure (HF) after anterior wall ST-elevation acute myocardial infarction (STEMI) remains difficult to determine due to inconsistencies in definitions.

Aims: Evaluate the 1-year incidence of HF after anterior wall STEMI in a real-world data set using a variety of potential definition criteria.

Methods: A retrospective cohort study of anonymized patient data was accessed through a federated health research network (TriNetX LLC) of 56 US healthcare organizations (US Collaborative Network). Patients were identified based upon ICD-10 criteria for anterior wall STEMI during the 10-year period from 2013-2022 and the absence of pre-specified signs or symptoms of HF. One-year incidence was calculated as 1 minus Kaplan-Meier survival at 12 months after anterior wall STEMI. The analysis utilized 5 different types of definition criteria for HF. Univariate Cox proportional hazards ratio was calculated to compare risk associated with potential risk factors.

Results: A total of 34,395 patients from the US Collaborative Network met eligibility criteria and were included in the analysis. One year incidence of HF based upon each definition criteria is summarized in table 1 and figure 1. Age ≥65 years, Black race, low density lipoprotein ≥100 mg/dL, elevated hemoglobin A1c, and BMI ≥35 kg/m ² were also associated with increased risk of HF.

Conclusions: Patients with anterior wall STEMI continue to be at high risk for new onset HF. In the absence of structured, prospective, systematically adjudicated diagnostic criteria, composite definitions are more likely to yield accurate estimates of HF incidence.