Objective: The present study investigates the prognostic impact of prior myocardial infarction (pMI) in patients hospitalized with heart failure with mildly reduced ejection fraction (HFmrEF) and ischemic cardiomyopathy (ICM).
Background: ICM represents the most common etiology of HFmrEF. While pMI is commonly regarded as a hallmark of ICM and has been associated with adverse outcomes in patients with reduced ejection fraction, data on its prognostic relevance in patients with HFmrEF are scarce.
Methods: Consecutive patients hospitalized with HFmrEF and ICM were retrospectively included at a single center. Patients were stratified according to the presence or absence of documented pMI. Kaplan–Meier analyses and multivariable Cox regression models were performed to investigate the association of pMI with the primary endpoint all-cause mortality at 30 months. The key secondary endpoint was HF-related rehospitalization.
Results: A total of 808 patients with HFmrEF and ICM were included, of whom 405 (50.1%) had a history of pMI. During a median follow-up of 30 months, pMI was not associated with all-cause mortality (HR 1.113; 95% CI 0.873–1.419; p = 0.389) or HF-related rehospitalization (HR 1.132; 95% CI 0.817–1.569; p = 0.456). After multivariable adjustment, pMI remained unrelated to long-term mortality (HR 1.063; 95% CI 0.805–1.402; p = 0.668) and HF-related rehospitalization (HR 0.960; 95% CI 0.664–1.386; p = 0.827). These findings were consistent across pre-specified subgroups.
Conclusion: In patients hospitalized with HFmrEF and ICM, pMI was not independently associated with long-term mortality or HF-related rehospitalization.
