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Correspondence to Author: Camila Tomasi⁸, Joel Eloi Belo Junior^1,3, Leocadia Felix de Araújo ^1,2, Orseli Marques Ferreira Neto¹¹, Delio Tiago Martins Malaquias¹, Marilda Bispo de Sá Oliveira⁹, Gabriel Leonardo Saraiva¹, Guilherme Guissone Martins¹, Maria Eduarda Kartabil Machado de Souza¹, Larissa Lauretto², Érica Miriam Fernandes Miranda Vão¹, José Carlos Ferreira da Silva¹, Felix Adriano Pietroluongo Vidal Tabera³, Victoria Geovana Tobias³, Andre Luiz Vergamini Dias³, Ingrid de Mariz Zane³, Letícia Brustolim Rosa⁴, Enzo Maruzzo Marques⁴, Rubens Rodrigues Tutela⁵, Ana Clara Lobo Ribeiro⁶, José Antônio do Nascimento Neto⁷, Francisco Rogério de Sousa Mota⁷, Cindy Alves Vilarinho¹, Giancarlo Damasceno Diegues², Thiago Augusto Rochetti Bezerra¹⁰. 

¹ Medical Student – Ribeirão Preto University (UNAERP), Guarujá/SP, Brazil.
² Medical Student – University of Western São Paulo (UNOESTE), Guarujá/SP, Brazil.
³ Medical Student – Nove de Julho University (UNINOVE), São Bernardo do Campo/SP, Brazil.
⁴ Medical Student – Faculty of Medical Sciences of São José dos Campos (Humanitas), SP, Brazil.
⁵ Medical Student – São Judas University, São Paulo/SP, Brazil.
⁶ Medical Student – University of Rio Verde (UNIRV), Aparecida de Goiânia Campus/GO, Brazil.
⁷ Medical Student – Central University of Paraguay, Ciudad del Este, Paraguay
⁸ Resident Physician in Internal Medicine – Santa Casa de Misericórdia de Goiânia, Brazil.
⁹ Medical Student. University of the Integration of the Americas (UNIDA), Ciudad del Este- Py
¹⁰Doctor of Medical Sciences. Ribeirão Preto School of Medicine, USP. Brazil.
¹¹ Doctor of Medicine, University of Rio Verde Campus Aparecida, Brazil.
¹² Graduate in Medicine from the Federal University of Fronteira Sul, Passo Fundo Campus, Rio Grande do Sul, Brazil.
¹³ Major Aviator of the Brazilian Air Force; Master’s degree in Human Operational Performance; Master’s degree in Intellectual Property and Technology Transfer for Innovation.

DOI: 10.52338/jocd.2025.5134

Abstract:

Acute myocardial infarction (AMI) remains one of the leading causes of global morbidity and mortality, despite advances in diagnostic and treatment strategies. Among its complications, post-ischemic heart failure (HF) stands out as a clinical outcome with a major impact, responsible for a significant increase in hospitalizations, reduced quality of life, and elevated mortality rates in the medium and long term. Understanding the pathophysiological evolution from AMI to HF is essential, as it involves factors such as the extent of myocardial necrosis, adverse ventricular remodeling, neurohormonal activation, and persistent inflammatory processes. The literature shows that the initial approach to AMI, especially early reperfusion by percutaneous coronary intervention or thrombolysis, reduces immediate mortality but does not eliminate the risk of developing HF. Studies such as those by O’Gara et al. (2013) and Ibanez et al. (2018) show a significant prevalence of HF even in scenarios with optimized reperfusion, suggesting that mechanisms other than coronary obstruction contribute to functional deterioration. In the context of chronic treatment, combined pharmacological therapies—including beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, aldosterone antagonists, and, more recently, sacubitril/valsartan—have been shown to reduce mortality and hospitalizations, as evidenced in multicenter studies such as those by McMurray et al. (2014) and Velazquez et al. (2016). In addition, international guidelines, such as those proposed by Ponikowski et al. (2016) and Heidenreich et al. (2022), reinforce the importance of risk stratification, multidisciplinary management, and continuous outpatient followup to prevent the progression of HF. Despite these achievements, significant challenges remain, especially in countries with unequal access to healthcare. Rates of post-infarction HF remain high, and the heterogeneity of outcomes across different populations reflects gaps in the universal application of evidence-based therapies. In addition, adverse ventricular remodeling remains a central process, reinforcing the need for preventive strategies and individualized therapies. This systematic review integrates the main findings in the literature on the relationship between AMI, subsequent ischemic events, and post-infarction HF, covering everything from the initial approach to definitive treatment. The results point to an evolutionary line of care, initially focused on reperfusion, later consolidated with combined pharmacotherapy, and more recently expanded to innovative and personalized therapies. It is concluded that post-ischemic HF should be understood not only as an inevitable complication but as an outcome that can be prevented, mitigated, and effectively treated, provided that guidelines are followed, access to therapies is expanded, and new technologies are incorporatedinto clinical care.

Keywords: Parkinson’s; Financial Distress; Informal Care, United Kingdom (List three to ten pertinent keywords specific to the article yet reasonably common within the subject discipline.).

Citation:

Dr. Thiago Augusto Rochetti Bezerra, Systematic Review On Ischemic Events And PostMyocardial Infarction Heart Failure: From Initial Approach To Definitive Treatment. Journal of Cardiovascular Diseases 2025.