Heart failure with preserved systolic function post-MI increased the adjusted risk of 1-year all-cause mortality compared to no heart failure (HR 2.1; 95% CI 1.7-2.6; P<0.0001).
Observational (n=3,166)
What is the prevalence and prognostic implication of congestive heart failure with preserved left ventricular systolic function after acute myocardial infarction?
Congestive heart failure with preserved left ventricular systolic function is common after acute myocardial infarction and is associated with a significantly increased risk of death.
Effect estimate: HR 2.1 (95% CI 1.7-2.6)
Absolute Event Rate: 22% vs 6%
p-value: p=<0.0001
AIMS: To characterise the prevalence, in-hospital complications, management, and long-term outcome of patients with congestive heart failure but preserved left ventricular systolic function after acute myocardial infarction. METHODS: 3166 consecutive patients screened for entry in the Bucindolol Evaluation in Acute Myocardial Infarction Trial with definite acute myocardial infarction and echocardiographic assessment of left ventricular systolic function were included between 1998 and 1999 in this prospective observational study. Main outcome measures were occurrences of in-hospital complications and all cause mortality. RESULTS: Congestive heart failure was seen during hospitalisation in 1464 patients (46%), 717 patients had preserved left ventricular systolic function (wall motion index > or =1.3 corresponding to ejection fraction > or =0.40), and 732 patients had systolic dysfunction (wall motion index <1.3). One year mortality in patients with no heart failure, heart failure with preserved systolic function, and heart failure with systolic dysfunction were 6, 22 and 35%, P<0.0001. Unadjusted risk of death from all causes associated with heart failure and preserved systolic function was 3.3 (95% CI 2.8-4.0), and after adjustment for baseline characteristics and left ventricular systolic function in multivariate Cox proportional hazards analysis the risk was 2.1 (95% CI 1.7-2.6), P<0.0001. CONCLUSIONS: Congestive heart failure is frequently present in patients with preserved left ventricular systolic function, and is associated with increased risk of in-hospital complications and death following acute myocardial infarction.
Møller et al. (Wed,) conducted a observational in Acute myocardial infarction (n=3,166). Heart failure with preserved systolic function vs. No heart failure was evaluated on All cause mortality (HR 2.1, 95% CI 1.7-2.6, p=<0.0001). Heart failure with preserved systolic function post-MI increased the adjusted risk of 1-year all-cause mortality compared to no heart failure (HR 2.1; 95% CI 1.7-2.6; P<0.0001).