Pulmonary HTN Predicts Heart Failure After Acute MI

Presence of pulmonary hypertension at index admission predicts risk of heart failure

THURSDAY, April 19 (HealthDay News) -- Pulmonary hypertension (PH) is a strong independent predictor of heart failure in patients with acute myocardial infarction (AMI), according to a study published in the May 1 issue of The American Journal of Cardiology.

Diab Mutlak, M.D., from the Technion Israel Institute of Technology in Haifa, and colleagues studied 1,054 patients diagnosed with AMI to investigate whether PH would be predictive of the risk of heart failure. Echocardiography was used to estimate pulmonary artery systolic pressure (PASP) at baseline admission, with PASP >35 mm Hg defined as PH.

The researchers found that 44.6 percent of patients had PH, which correlated significantly with age, decreased ejection fraction, advanced diastolic dysfunction, and moderate/severe mitral regurgitation. Compared with other echocardiographic measures, the area under the receiver operating characteristic curve was significantly higher for estimated PASP (0.74). After adjusting for other variables, PH was significantly associated with the risk of heart failure (hazard ratio, 3.10). The addition of PASP to a model containing clinical and echocardiographic risk factors resulted in a significant net reclassification improvement (0.21).

"In AMI, PH at the index admission is a useful marker in unmasking latent subclinical heart failure and predicting the development of overt heart failure," the authors write.

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