Cardiac Consequences of Myocardial Infarction: An Analytical Overview of Complications in Recent Clinical Research

Abstract

Acute myocardial infarction (MI) remains a major cause of morbidity and mortality globally. Despite advances in reperfusion and secondary prevention, MI survivors face long-term complications such as heart failure (HF), arrhythmias, mechanical issues, and adverse cardiac remodeling. This review synthesizes recent clinical findings (2015–2025) on post-MI complications, focusing on HF, arrhythmias, mechanical complications, and ventricular remodeling, and highlights clinical implications and research gaps. We conducted a focused review of 15 major studies, including large randomized trials, registry analyses, and observational studies,  Chronic HF remains a common long-term outcome despite neurohormonal therapies like ARNI and SGLT2 inhibitors, which modestly reduce HF hospitalizations but show no significant impact on mortality. Life-threatening arrhythmias have decreased with modern reperfusion, but early ventricular arrhythmias increase in-hospital death risk by more than 3.8-fold. Mechanical complications, such as ventricular septal defects and papillary muscle rupture, are rare (<0.1%) but remain associated with high mortality, especially with delayed care. Adverse ventricular remodeling, leading to HF, is influenced by comorbidities like diabetes and obesity. Therapies like ARNI and SGLT2 inhibitors slow remodeling but do not fully prevent HF. Post-MI complications, particularly HF, remain a significant challenge despite advances in care. Further research is needed to develop more effective therapies and personalized care strategies to improve outcomes for MI survivors.