Prognostic Implications of Mid-Range Left Ventricular Ejection Fraction on Patients Presenting With ST- Segment Elevation Myocardial Infarction
Abstract The new European Society of Cardiology guidelines reclassified heart failure according to left ventricular ejection fraction (LVEF), recognizing patients with mid-range EF [(mrEF), 40-49%)] as a distinct group. We sought to investigate the clinical profile, in-hospital outcomes and long ter...
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| Veröffentlicht in: | The American journal of cardiology 2017-07, Vol.120 (2), p.186-190 |
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| creator | Margolis, Gilad, MD Khoury, Shafik, MD Ben-Shoshan, Jeremy, MD, PhD Letourneau-Shesaf, Sevan, MD Flint, Nir, MD Keren, Gad, MD Shacham, Yacov, MD |
| description | Abstract The new European Society of Cardiology guidelines reclassified heart failure according to left ventricular ejection fraction (LVEF), recognizing patients with mid-range EF [(mrEF), 40-49%)] as a distinct group. We sought to investigate the clinical profile, in-hospital outcomes and long term mortality of ST elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI) who had mrEF. We conducted a retrospective study of 2086 consecutive STEMI patients between December 2007 and June 2016 who underwent primary PCI and had a comprehensive echocardiographic examination performed within 72 h of hospital admission. Patients were stratified according to their LVEF – mrEF (40-49%), reduced EF [(rEF), 50%] groups and evaluated for baseline characteristics, in-hospital outcomes, as well as for long term mortality. A total of 858/2086 (41%) patients had mrEF, 215/2086 (10%) had rEF and 1013/2086 (48%) had pEF. Patients with mrEF had nearly similar baseline co-morbidities and similar 30-day mortality compared to patients with pEF (2% vs.1%, p=0.17). In a univariate analysis, long term mortality was higher compared with those with pEF (9.8%vs. 7.2%, p |
| doi_str_mv | 10.1016/j.amjcard.2017.04.005 |
| format | Article |
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We sought to investigate the clinical profile, in-hospital outcomes and long term mortality of ST elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI) who had mrEF. We conducted a retrospective study of 2086 consecutive STEMI patients between December 2007 and June 2016 who underwent primary PCI and had a comprehensive echocardiographic examination performed within 72 h of hospital admission. Patients were stratified according to their LVEF – mrEF (40-49%), reduced EF [(rEF), <40%], and preserved EF [(pEF), > 50%] groups and evaluated for baseline characteristics, in-hospital outcomes, as well as for long term mortality. A total of 858/2086 (41%) patients had mrEF, 215/2086 (10%) had rEF and 1013/2086 (48%) had pEF. Patients with mrEF had nearly similar baseline co-morbidities and similar 30-day mortality compared to patients with pEF (2% vs.1%, p=0.17). In a univariate analysis, long term mortality was higher compared with those with pEF (9.8%vs. 7.2%, p<0.01). In a multivariate Cox regression model mrEF was independently associated with increased long term mortality risk compared with pEF (Hazard ratio 1.4, 95% CI 1.02-1.93, P =0.04). In conclusion, among STEMI patients, those with mrEF at presentation constitute a distinct group in terms of baseline characteristics, in-hospital outcomes and long term mortality.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2017.04.005</identifier><identifier>PMID: 28532775</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Cardiology ; Cardiovascular ; Cardiovascular disease ; Echocardiography ; Ejection fraction ; Electrocardiography ; Female ; Health risk assessment ; Heart ; Heart attacks ; Heart diseases ; Heart failure ; Humans ; Intervention ; Israel - epidemiology ; Laboratories ; Male ; Medical prognosis ; Mortality ; Myocardial infarction ; Patients ; Prognosis ; Regression analysis ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; ST Elevation Myocardial Infarction - diagnosis ; ST Elevation Myocardial Infarction - mortality ; ST Elevation Myocardial Infarction - physiopathology ; Stroke Volume - physiology ; Survival Rate - trends ; Time Factors ; Ventricle ; Ventricular Function, Left - physiology</subject><ispartof>The American journal of cardiology, 2017-07, Vol.120 (2), p.186-190</ispartof><rights>Elsevier Inc.</rights><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Jul 15, 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-256e17e49b0f73628a4b4ed5c753b357126c48d16baf5976698659459150df723</citedby><cites>FETCH-LOGICAL-c448t-256e17e49b0f73628a4b4ed5c753b357126c48d16baf5976698659459150df723</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914917306938$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28532775$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Margolis, Gilad, MD</creatorcontrib><creatorcontrib>Khoury, Shafik, MD</creatorcontrib><creatorcontrib>Ben-Shoshan, Jeremy, MD, PhD</creatorcontrib><creatorcontrib>Letourneau-Shesaf, Sevan, MD</creatorcontrib><creatorcontrib>Flint, Nir, MD</creatorcontrib><creatorcontrib>Keren, Gad, MD</creatorcontrib><creatorcontrib>Shacham, Yacov, MD</creatorcontrib><title>Prognostic Implications of Mid-Range Left Ventricular Ejection Fraction on Patients Presenting With ST- Segment Elevation Myocardial Infarction</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Abstract The new European Society of Cardiology guidelines reclassified heart failure according to left ventricular ejection fraction (LVEF), recognizing patients with mid-range EF [(mrEF), 40-49%)] as a distinct group. We sought to investigate the clinical profile, in-hospital outcomes and long term mortality of ST elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI) who had mrEF. We conducted a retrospective study of 2086 consecutive STEMI patients between December 2007 and June 2016 who underwent primary PCI and had a comprehensive echocardiographic examination performed within 72 h of hospital admission. Patients were stratified according to their LVEF – mrEF (40-49%), reduced EF [(rEF), <40%], and preserved EF [(pEF), > 50%] groups and evaluated for baseline characteristics, in-hospital outcomes, as well as for long term mortality. A total of 858/2086 (41%) patients had mrEF, 215/2086 (10%) had rEF and 1013/2086 (48%) had pEF. Patients with mrEF had nearly similar baseline co-morbidities and similar 30-day mortality compared to patients with pEF (2% vs.1%, p=0.17). In a univariate analysis, long term mortality was higher compared with those with pEF (9.8%vs. 7.2%, p<0.01). In a multivariate Cox regression model mrEF was independently associated with increased long term mortality risk compared with pEF (Hazard ratio 1.4, 95% CI 1.02-1.93, P =0.04). In conclusion, among STEMI patients, those with mrEF at presentation constitute a distinct group in terms of baseline characteristics, in-hospital outcomes and long term mortality.</description><subject>Cardiology</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Echocardiography</subject><subject>Ejection fraction</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Humans</subject><subject>Intervention</subject><subject>Israel - epidemiology</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>ST Elevation Myocardial Infarction - diagnosis</subject><subject>ST Elevation Myocardial Infarction - mortality</subject><subject>ST Elevation Myocardial Infarction - physiopathology</subject><subject>Stroke Volume - physiology</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><subject>Ventricle</subject><subject>Ventricular Function, Left - physiology</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkttuEzEQhlcIREPhEUCWuOFmF8-uD-sbUFWlJVIqIlLg0nK8s8HLHoK9qZSn4JXrbQJIvUGy5IO--Wc8_yTJa6AZUBDvm8x0jTW-ynIKMqMso5Q_SWZQSpWCguJpMqOU5qkCps6SFyE08QrAxfPkLC95kUvJZ8nvlR-2_RBGZ8mi27XOmtENfSBDTW5clX4x_RbJEuuRfMN-9M7uW-PJvEE7ceTKm-MhrlUMjUwgK48hHly_Jd_d-IOsb1Oyxm0X38i8xbuHFOTmMEz1O9OSRV8b_6DzMnlWmzbgq9N-nny9mt9efkqXn68XlxfL1DJWjmnOBYJEpja0loXIS8M2DCtuJS82BZeQC8vKCsTG1FxJIVQpuGJcAadVLfPiPHl31N354dcew6g7Fyy2relx2AcNKnaV50KWEX37CG2Gve9jdZECgJLJAiLFj5T1Qwgea73zrjP-oIHqyTHd6JNjenJMU6ajYzHuzUl9v-mw-hv1x6IIfDwCGNtx59DrYGObLVbORxN0Nbj_pvjwSMG2ro9Otz_xgOHfb3TINdXraWymqQFZUKGKsrgHgjG-jA</recordid><startdate>20170715</startdate><enddate>20170715</enddate><creator>Margolis, Gilad, MD</creator><creator>Khoury, Shafik, MD</creator><creator>Ben-Shoshan, Jeremy, MD, PhD</creator><creator>Letourneau-Shesaf, Sevan, MD</creator><creator>Flint, Nir, MD</creator><creator>Keren, Gad, MD</creator><creator>Shacham, Yacov, MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20170715</creationdate><title>Prognostic Implications of Mid-Range Left Ventricular Ejection Fraction on Patients Presenting With ST- Segment Elevation Myocardial Infarction</title><author>Margolis, Gilad, MD ; Khoury, Shafik, MD ; Ben-Shoshan, Jeremy, MD, PhD ; Letourneau-Shesaf, Sevan, MD ; Flint, Nir, MD ; Keren, Gad, MD ; Shacham, Yacov, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-256e17e49b0f73628a4b4ed5c753b357126c48d16baf5976698659459150df723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Cardiology</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Echocardiography</topic><topic>Ejection fraction</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Heart diseases</topic><topic>Heart failure</topic><topic>Humans</topic><topic>Intervention</topic><topic>Israel - 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Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Margolis, Gilad, MD</au><au>Khoury, Shafik, MD</au><au>Ben-Shoshan, Jeremy, MD, PhD</au><au>Letourneau-Shesaf, Sevan, MD</au><au>Flint, Nir, MD</au><au>Keren, Gad, MD</au><au>Shacham, Yacov, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Implications of Mid-Range Left Ventricular Ejection Fraction on Patients Presenting With ST- Segment Elevation Myocardial Infarction</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2017-07-15</date><risdate>2017</risdate><volume>120</volume><issue>2</issue><spage>186</spage><epage>190</epage><pages>186-190</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><abstract>Abstract The new European Society of Cardiology guidelines reclassified heart failure according to left ventricular ejection fraction (LVEF), recognizing patients with mid-range EF [(mrEF), 40-49%)] as a distinct group. We sought to investigate the clinical profile, in-hospital outcomes and long term mortality of ST elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI) who had mrEF. We conducted a retrospective study of 2086 consecutive STEMI patients between December 2007 and June 2016 who underwent primary PCI and had a comprehensive echocardiographic examination performed within 72 h of hospital admission. Patients were stratified according to their LVEF – mrEF (40-49%), reduced EF [(rEF), <40%], and preserved EF [(pEF), > 50%] groups and evaluated for baseline characteristics, in-hospital outcomes, as well as for long term mortality. A total of 858/2086 (41%) patients had mrEF, 215/2086 (10%) had rEF and 1013/2086 (48%) had pEF. Patients with mrEF had nearly similar baseline co-morbidities and similar 30-day mortality compared to patients with pEF (2% vs.1%, p=0.17). In a univariate analysis, long term mortality was higher compared with those with pEF (9.8%vs. 7.2%, p<0.01). In a multivariate Cox regression model mrEF was independently associated with increased long term mortality risk compared with pEF (Hazard ratio 1.4, 95% CI 1.02-1.93, P =0.04). In conclusion, among STEMI patients, those with mrEF at presentation constitute a distinct group in terms of baseline characteristics, in-hospital outcomes and long term mortality.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28532775</pmid><doi>10.1016/j.amjcard.2017.04.005</doi><tpages>5</tpages></addata></record> |
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| subjects | Cardiology Cardiovascular Cardiovascular disease Echocardiography Ejection fraction Electrocardiography Female Health risk assessment Heart Heart attacks Heart diseases Heart failure Humans Intervention Israel - epidemiology Laboratories Male Medical prognosis Mortality Myocardial infarction Patients Prognosis Regression analysis Retrospective Studies Risk Factors Severity of Illness Index ST Elevation Myocardial Infarction - diagnosis ST Elevation Myocardial Infarction - mortality ST Elevation Myocardial Infarction - physiopathology Stroke Volume - physiology Survival Rate - trends Time Factors Ventricle Ventricular Function, Left - physiology |
| title | Prognostic Implications of Mid-Range Left Ventricular Ejection Fraction on Patients Presenting With ST- Segment Elevation Myocardial Infarction |
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