In-hospital measurement of left ventricular ejection fraction and one-year outcomes in acute coronary syndromes: results from the IMMEDIATE Trial

Cardiovascular Ultrasound

Research

David Kent¹  Robin Ruthazer²  Joni R. Beshansky^{3    4}  Madhab Ray⁵  Hadeel Alkofide⁶  Jayanta T. Mukherjee⁷  Warren J. Manning⁸  Gordon S. Huggins⁹ 

[1] Center for Cardiovascular Health Services Research, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington St, #63, 02111, Boston, MA, USA;Center for Cardiovascular Health Services Research, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington St, #63, 02111, Boston, MA, USA;Department of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Medical Center Harvard Medical School, Boston, MA, USA;Center for Cardiovascular Health Services Research, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington St, #63, 02111, Boston, MA, USA;Regis College, Weston, MA, USA;Center for Cardiovascular Health Services Research, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington St, #63, 02111, Boston, MA, USA;Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA;Clinical and Translational Science Graduate Program, Sackler School of Biomedical Sciences, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA;Clinical and Translational Science Graduate Program, Sackler School of Biomedical Sciences, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA;College of Pharmacy, King Saud University, Riyadh, Saudi Arabia;Clinical and Translational Science Graduate Program, Sackler School of Biomedical Sciences, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA;Department of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Medical Center Harvard Medical School, Boston, MA, USA;Riverside Methodist Hospital, Ohio Health Heart and Vascular Physicians, Columbus, OH, USA;Department of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Medical Center Harvard Medical School, Boston, MA, USA;MCRI Center for Translational Genomics, Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, USA;

关键词: Acute coronary syndromes;    Glucose-insulin-potassium;    Left ventricular ejection fraction;    Death;    Hospitalization from heart failure;   

DOI  :  10.1186/s12947-016-0068-1

 received in 2016-01-26, accepted in 2016-06-22,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundIn 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.MethodsWe performed a retrospective analysis of 445 participants in the IMMEDIATE Trial who had LVEF measured by left ventriculography or echocardiogram during hospitalization.ResultsAdjusting 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).ConclusionsAmong 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.

【 授权许可】

CC BY   
© Mukherjee et al. 2016