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- Title
In-hospital measurement of left ventricular ejection fraction and one-year outcomes in acute coronary syndromes: results from the IMMEDIATE Trial.
- Authors
Mukherjee, Jayanta T.; Beshansky, Joni R.; Ruthazer, Robin; Alkofide, Hadeel; Ray, Madhab; Kent, David; Manning, Warren J.; Huggins, Gordon S.; Selker, Harry P.
- Abstract
<bold>Background: </bold>In patients with acute coronary syndrome (ACS), reduced left ventricular ejection fraction (LVEF) is a known marker for increased mortality. However, the relationship between LVEF measured during index ACS hospitalization and mortality and heart failure (HF) within 1 year are less well-defined.<bold>Methods: </bold>We performed a retrospective analysis of 445 participants in the IMMEDIATE Trial who had LVEF measured by left ventriculography or echocardiogram during hospitalization.<bold>Results: </bold>Adjusting for age and coronary artery disease (CAD) history, lower LVEF was significantly associated with 1-year mortality or hospitalization for HF. For every 5 % LVEF reduction, the hazard ratio [HR] was 1.26 (95 % CI 1.15, 1.38, P < 0.001). Participants with LVEF < 40 % had higher hazard of 1-year mortality or HF hospitalization than those with LVEF > 40 (HR 3.59; 95 % CI 2.05, 6.27, P < 0.001). The HRs for the association of LVEF with the study outcomes were similar whether measured by left ventriculography or by echocardiography, (respectively, HR 1.32; 95 % CI 1.15, 1.51 and 1.21; 95 % CI 1.106, 1.35, interaction P = 0.32) and whether done within 24 h or not within 24 h (respectively, HR 1.28; 95 % CI 1.10, 1.50 and 1.23; 95 % CI 1.10, 1.38, interaction P = 0.67).<bold>Conclusions: </bold>Among patients with ACS, lower in-hospital LVEF is associated with increased 1-year mortality or hospitalization for HF, regardless of the method or timing of the LVEF assessment. This has prognostic implications for clinical practice and suggests the possibility of using various methods of LVEF determination in clinical research.
- Subjects
ACUTE coronary syndrome; HEART failure; HOSPITAL care; CORONARY disease; BIOMARKERS; LEFT heart ventricle; HEART physiology; COMPARATIVE studies; ECHOCARDIOGRAPHY; HOSPITAL patients; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; PROGNOSIS; RESEARCH; RESEARCH funding; TIME; EVALUATION research; RANDOMIZED controlled trials; BLIND experiment; RETROSPECTIVE studies; STROKE volume (Cardiac output); DISEASE complications; DIAGNOSIS
- Publication
Cardiovascular Ultrasound, 2016, p1
- ISSN
1476-7120
- Publication type
journal article
- DOI
10.1186/s12947-016-0068-1