---
title: "Incidence and 1-Year Mortality After In-Hospital Heart Failure in First STEMI Patients"
id: "pubmed-42907221"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42907221"
content_type: "clinical_feed_article"
specialty: "Cardiology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42907221/"
doi: "10.3760/cma.j.cn112148-20260514-00314"
published_at: "2026-10-24T00:00:00.000Z"
evidence_level: "English Abstract"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Incidence and 1-Year Mortality After In-Hospital Heart Failure in First STEMI Patients
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42907221
- **Specialty:** [Cardiology](https://medichelpline.com/clinical-feed/cardiology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42907221/)
- **DOI:** [10.3760/cma.j.cn112148-20260514-00314](https://doi.org/10.3760%2Fcma.j.cn112148-20260514-00314)
- **Published At:** 2026-10-24T00:00:00.000Z
- **Evidence Rating:** English Abstract
## Executive GIST (TL;DR)
- Investigators used the Henan STEMI registry, a multicentre prospective observational dataset in central China, to study first-ever **STEMI** patients with no prior myocardial infarction or heart failure. - The final analytic cohort comprised 4,737 first STEMI patients; median age 62.8 years and 24.4% female. - During hospitalization 1,978 patients (41.8%) developed **heart failure (HF)** after the index myocardial infarction. - Among those with HF, subgrouping by last in-hospital echocardiogram left ventricular ejection fraction (**LVEF**) produced HFrEF (LVEF≤40%) in 268 (13.5%), HFmrEF (LVEF 41–49%) in 309 (15.6%), HFpEF (LVEF≥50%) in 707 (35.7%), and 694 (35.1%) with missing LVEF. - Follow-up at 1 year was completed in 3,967 patients (83.7% of cohort). - One-year mortality for patients who developed in-hospital HF was 23.3% versus 5.8% for those without HF; the difference reached log-rank P <0.001. - Mortality by HF subgroup: HFrEF 29.6%, HFmrEF 20.8%, HFpEF 11.7%, and HF with missing LVEF 34.1%. - Multivariable Cox frailty models found in-hospital HF following MI associated with increased 1-year mortality (HR = 2.13, 95% CI: 1.70–2.67) using the non-HF group as reference. - Among HF subgroups, authors reported the lowest adjusted 1-year mortality risk for **HFpEF** (HR = 1.59, 95% CI: 1.16–2.17) and the highest for HF with missing LVEF (HR = 2.49, 95% CI: 1.91–3.26). - The registry-based design, substantial proportion with missing LVEF, and observational nature were discussed as study constraints; the source did not report detailed treatment, reperfusion timing, or in-hospital management strategies in the abstract.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Henan Institute of Cardiovascular Epidemiology, Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, Central China Fuwai Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital, Zhengzhou 451464, China. * 2 Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, National Health Commission Key Laboratory of Cardiovascular Regenerative Medicine, Henan Center for Cardiovascular Diseases, Central China Fuwai Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital & Central China Branch of National Center for Cardiovascular Diseases, Zhengzhou 451464, China. * 3 Lankenau Institute for Medical Research, Wynnewood 19096, USA. * PMID: **42907221** * DOI: [ 10.3760/cma.j.cn112148-20260514-00314 ](https://doi.org/10.3760/cma.j.cn112148-20260514-00314) Item in Clipboard Observational Study # [The incidence and 1-year prognosis of heart failure following myocardial infarction during hospitalization in patients with first STEMI] [Article in Chinese] Y Zhang et al. Zhonghua Xin Xue Guan Bing Za Zhi. 2026. Show details Display options Display options Format Abstract PubMed PMID Zhonghua Xin Xue Guan Bing Za Zhi Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Zhonghua+Xin+Xue+Guan+Bing+Za+Zhi%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Zhonghua+Xin+Xue+Guan+Bing+Za+Zhi%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42907221/) . 2026 Oct 24;54(10):1164-1171. doi: 10.3760/cma.j.cn112148-20260514-00314. ### Authors [Y Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+Y&cauthor_id=42907221)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42907221/#short-view-affiliation-1 "Henan Institute of Cardiovascular Epidemiology, Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, Central China Fuwai Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital, Zhengzhou 451464, China."), [S Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+S&cauthor_id=42907221)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42907221/#short-view-affiliation-1 "Henan Institute of Cardiovascular Epidemiology, Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, Central China Fuwai Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital, Zhengzhou 451464, China."), [W Yang](https://pubmed.ncbi.nlm.nih.gov/?term=Yang+W&cauthor_id=42907221)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42907221/#short-view-affiliation-1 "Henan Institute of Cardiovascular Epidemiology, Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, Central China Fuwai Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital, Zhengzhou 451464, China."), [D D Qi](https://pubmed.ncbi.nlm.nih.gov/?term=Qi+DD&cauthor_id=42907221)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42907221/#short-view-affiliation-2 "Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, National Health Commission Key Laboratory of Cardiovascular Regenerative Medicine, Henan Center for Cardiovascular Diseases, Central China Fuwai Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital & Central China Branch of National Center for Cardiovascular Diseases, Zhengzhou 451464, China."), [Z Y Zhu](https://pubmed.ncbi.nlm.nih.gov/?term=Zhu+ZY&cauthor_id=42907221)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42907221/#short-view-affiliation-1 "Henan Institute of Cardiovascular Epidemiology, Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, Central China Fuwai Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital, Zhengzhou 451464, China."), [X P Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+XP&cauthor_id=42907221)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42907221/#short-view-affiliation-1 "Henan Institute of Cardiovascular Epidemiology, Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, Central China Fuwai Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital, Zhengzhou 451464, China."), [G X Yan](https://pubmed.ncbi.nlm.nih.gov/?term=Yan+GX&cauthor_id=42907221)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42907221/#short-view-affiliation-3 "Lankenau Institute for Medical Research, Wynnewood 19096, USA."), [C Y Gao](https://pubmed.ncbi.nlm.nih.gov/?term=Gao+CY&cauthor_id=42907221)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42907221/#short-view-affiliation-1 "Henan Institute of Cardiovascular Epidemiology, Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, Central China Fuwai Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital, Zhengzhou 451464, China.") ### Affiliations * 1 Henan Institute of Cardiovascular Epidemiology, Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, Central China Fuwai Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital, Zhengzhou 451464, China. * 2 Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, National Health Commission Key Laboratory of Cardiovascular Regenerative Medicine, Henan Center for Cardiovascular Diseases, Central China Fuwai Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital & Central China Branch of National Center for Cardiovascular Diseases, Zhengzhou 451464, China. * 3 Lankenau Institute for Medical Research, Wynnewood 19096, USA. * PMID: **42907221** * DOI: [ 10.3760/cma.j.cn112148-20260514-00314 ](https://doi.org/10.3760/cma.j.cn112148-20260514-00314) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract in [ English, ](https://pubmed.ncbi.nlm.nih.gov/42907221/#eng-abstract) [ Chinese ](https://pubmed.ncbi.nlm.nih.gov/42907221/#zho-abstract) **Objective:** To investigate the incidence of in-hospital heart failure (HF) following myocardial infarction (MI) and 1-year mortality in patients with first ST-segment elevation myocardial infarction (STEMI), and to compare the 1-year mortality risk among different types of HF. **Methods:** Data were derived from the Henan STEMI registry, which was a multicentre, prospective, observational study in central China. After excluding patients with a history of MI or HF, patients with first STEMI were divided into the HF and non-HF groups according to the occurrence of in-hospital HF. Based on the left ventricular ejection fraction (LVEF) measured on the last echocardiogram during hospitalization, patients with HF were classified into HF with preserved ejection fraction (HFpEF, LVEF≥50%), HF with mildly reduced ejection fraction (HFmrEF, LVEF 41%-49%), HF with reduced ejection fraction (HFrEF, LVEF≤40%), and HF with missing LVEF. Survival analysis was performed using the Kaplan-Meier method, and differences between groups were assessed with the log-rank test. Multivariate Cox frailty models were used to analyze the associations of HF status (present vs. absent) and different LVEF subgroups with 1-year mortality, using the non-HF group as the reference. **Results:** A total of 4 737 patients with first STEMI were included in the final analysis, with a median age of 62.8 (52.4, 70.8) years, of whom 1 158 (24.4%) were female. During hospitalization, 1 978 cases (41.8%) developed HF following MI, including 268 (13.5%) with HFrEF, 309 (15.6%) with HFmrEF, 707 (35.7%) with HFpEF, and 694 (35.1%) with missing LVEF. A total of 3 967 (83.7%) patients completed the 1-year follow-up. The 1-year mortality was significantly higher among STEMI patients complicated by HF than in those without (23.3% (391/1 680) vs. 5.8% (132/2 287), log-rank _P_ <0.001). Specifically, the rates were 29.6% (67/226) for HFrEF, 20.8% (53/255) for HFmrEF, 11.7% (72/615) for HFpEF and 34.1% (199/584) for HF with missing LVEF. Multivariate Cox frailty models identified in-hospital HF following MI as a risk factor for 1-year mortality (_HR_ =2.13, 95%_CI_ : 1.70-2.67). Notably, HFpEF was associated with the lowest risk of 1-year mortality (_HR_ =1.59, 95%_CI_ : 1.16-2.17), while the HF group with missing LVEF carried the highest risk (_HR_ =2.49, 95%_CI_ : 1.91-3.26). **Conclusions:** The incidence of HF following first STEMI during hospitalization was 41.8%, with a corresponding 1-year mortality of 23.3%. In-hospital HF following MI is a risk factor for 1-year mortality in patients with STEMI. Prognosis differed notably across HF subgroups: HFpEF was associated with the lowest risk, whereas patients with missing LVEF had the worst outcome. **目的：** 探讨初次ST段抬高型心肌梗死（STEMI）患者住院期间心肌梗死（心梗）后心力衰竭（心衰）的发生率和1年死亡率，并比较不同类型心衰的1年死亡风险。 **方法：** 数据来自多中心前瞻性观察性研究——河南STEMI注册登记研究。排除该研究中既往有心梗或心衰病史的患者，依据住院期间是否发生心衰，分为心衰组和无心衰组。心衰组依据住院期间最后一次超声心动图测量的左心室射血分数（LVEF）分为射血分数保留的心衰（HFpEF，LVEF≥50%）、射血分数轻度降低的心衰（HFmrEF，LVEF 41%~49%）、射血分数降低的心衰（HFrEF，LVEF≤40%）及LVEF值缺失的心衰组。采用Kaplan-Meier法进行生存分析并进行log-rank检验。以无心衰组为参照，采用多因素Cox脆弱模型分析有无心衰及不同LVEF分组与1年内死亡率的关系。 **结果：** 最终纳入4 737例初次STEMI患者，年龄为62.8（52.4，70.8）岁，女性1 158例（24.4%）。住院期间发生心梗后心衰1 978例（41.8%），其中包括HFrEF患者268例（13.5%），HFmrEF患者309例（15.6%），HFpEF患者707例（35.7%）及LVEF值缺失的心衰患者694例（35.1%）。共有3 967例（83.7%）患者完成1年随访。心衰组STEMI患者的1年死亡率高于无心衰组［23.3%（391/1 680）比5.8%（132/2 287），log-rank _P_ <0.001］。HFrEF、HFmrEF、HFpEF及LVEF值缺失的心衰组1年死亡率分别为29.6%（67/226）、20.8%（53/255）、11.7%（72/615）和34.1%（199/584）。多因素Cox脆弱模型分析显示，住院期间心梗后心衰是1年死亡的危险因素（ _HR_ =2.13，95%_CI_ ：1.70~2.67）。其中HFpEF组1年死亡风险最低（ _HR_ =1.59，95%_CI_ ：1.16~2.17），LVEF值缺失的心衰组1年死亡风险最高（ _HR_ =2.49，95%_CI_ ：1.91~3.26）。 **结论：** 初次STEMI患者住院期间心梗后心衰的发生率为41.8%，1年死亡率达23.3%。住院期间心梗后心衰是STEMI患者1年死亡的危险因素，且各心衰亚组间预后存在差异：HFpEF患者风险相对最低，LVEF值缺失者预后最差。. 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