Heart failure (HF) is one of the significant complications in patients with myocardial infarction (MI), leading to increased risk for cardiovascular morbidity and mortality.1 Left ventricular ejection fraction (LVEF) is a crucial parameter in HF assessment and management, although the differences in mortality are little different between HF with LVEF≥50% or HF with preserved ejection fraction (HFpEF) in patients with post-MI compared with HF with LVEF≤40% or HF with reduced ejection fraction (HFrEF).2 However, mortality rate is greater in HF cases developing >3 days following MI compared with less than or equal to 3 days after MI.2 Therefore, early identification of HF in high-risk populations, particularly post-MI, is essential for improving outcomes.

Risk factors for developing HF after MI vary and are influenced by whether the patient has HFrEF or HFpEF. Common predictors include older age, prior hypertension, diabetes and atrial fibrillation. HFrEF is more commonly associated with male sex, higher neutrophil counts and reduced LVEF at baseline. In contrast, HFpEF is often linked to female sex, prior kidney dysfunction and larger left atrial volume index.1

In this issue of Heart, Wu et al 3 report two new indicators for incident HFpEF after MI, namely …