Epidemiología y pronóstico de la insuficiencia cardiaca postinfarto

Heart failure is still a very frequent complication of acute myocardial infarction even though its incidence has decreased during the last few years. Combination of these two disease entities implies a very poor prognosis, quadrupling mortality in affected patients. In one-third of all individuals with infarcts, heart failure develops after hospital admission. It is precisely these patients who have the worst prognosis. In this situation, the early identification of those at an increased risk (e.g., elderly, tachycardiac, and diabetic patients) is fundamental so that use can be made of the most aggressive therapeutic measures for preventing this feared complication. The prognosis for patients with heart failure worsens as the degree of their ventricular dysfunction increases. However, ventricular dysfunction is itself a determinant of a poor prognosis, even in the absence of clinical heart failure.