R E C C a r d i o C l i n i c s . 2 0 2 0; 5 5(1) :8–14 w w w.reccardioclinics.org REC: CardioClinics Original article Incidence, prognosis and predictors of heart failure after acute myocardial infarction María Melendo-Viu a,* , Emad Abu-Assi a , Sergio Manzano-Fernández b , Pedro J. Flores-Blanco b , Francisco Cambronero-Sánchez b , David Dobarro Pérez a , María Cespón Fernández a , María José Sánchez Galian b , Miriam Gómez Molina b , Berenice Caneiro-Queija a , Rafael Cobas Paz a , Isabel Mu ˜ noz Pousa a , Mariano Valdés b , Domingo Pascual Figal b , Andrés ͘ niguez-Romo a a Departamento de Cardiología, Hospital Universitario Álvaro-Cunqueiro, Vigo, Pontevedra, Spain b Departamento de Cardiología, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain a r t i c l e i n f o Article history: Received 18 June 2019 Accepted 7 August 2019 Available online 11 September 2019 Keywords: Heart failure Acute myocardial infarction Left ventricular ejection fraction Mortality a b s t r a c t Introduction and objectives: To study the incidence, predictors and prognosis of follow-up de novo heart failure (HF) after discharge for acute myocardial infarction (AMI) in patients with left ventricular ejection fraction (LVEF) ≥ 50% and without previous history of HF. Methods: Retrospective multicenter registry that includes 2158 consecutive patients dis- charged for AMI, from January 2011 to December 2015, with LVEF ≥ 50% and without history of HF. The association between clinical variables and the development of de novo HF was assessed by Fine–Gray proportional hazards regression analysis, accounting for death as a competing episode. The adjusted effect of post-discharge HF on subsequent mortality was investigated using extended Cox proportional hazards model. Results: During follow-up (20.1 ± 11.8 months), 60 patients (2.8%) had HF admissions, with a cumulative incidence function of 1.7 per 100 patient-year. Age ≥ 70 years, hypertension, atrial fibrillation, and renal dysfunction were independent risk factors for follow-up HF. The HF incidence rate after surviving AMI increased with a higher number of risk factors, from 0.1% in patients with 0, to 1.8%, 3.8%, 15.3%, and 19% in patients with 1, 2, 3, and 4 risk factors, respectively (P < .0001). Patients who experience follow-up new-onset HF had a 3.77-fold increased risk of death compared with other AMI survivors. Conclusions: De novo HF after hospital discharge for ACS in patients with LVEF ≥ 50% is an independent predictor of follow-up death. Fortunately, it is an infrequent post-AMI compli- cation and is easily predictable the combination of 4 clinical risk factors. © 2019 Sociedad Espa ˜ nola de Cardiolog´ ıa. Published by Elsevier Espa ˜ na, S.L.U. All rights reserved. Abbreviations: AF, atrial fibrillation; AMI, acute myocardial infarction; HF, heart failure; LVEF, left ventricular ejection fraction. ∗ Corresponding author. E-mail address: mariamelviu@gmail.com (M. Melendo-Viu). https://doi.org/10.1016/j.rccl.2019.08.001 2605-1532/© 2019 Sociedad Espa ˜ nola de Cardiolog´ ıa. Published by Elsevier Espa ˜ na, S.L.U. All rights reserved.