LV systolic dysfunction after myocardial infarction is associated with higher rates of dyspnoea and readmission.
Observational (n=49,654)
Yes
Does reduced left ventricular ejection fraction after a first myocardial infarction increase symptom burden and reduce adherence to secondary prevention measures compared to normal ejection fraction?
Patients with severe left ventricular systolic dysfunction after a first MI experience a substantially higher symptom burden, more readmissions, and lower participation in secondary prevention programs at 1 year compared to those with normal EF.
Effect estimate: OR 7.45 (95% CI (6.22 to 8.92))
Absolute Event Rate: 32.3% vs 5.6%
p-value: p=<0.001
Background There is a lack of contemporary data describing patients with left ventricular (LV) systolic dysfunction post myocardial infarction (MI) in terms of symptom burden and secondary prevention measures. The aim of this study was to describe patients with various degrees of LV systolic dysfunction after a first MI, their symptom burden, quality of life and adherence to recommended secondary prevention measures in a nationwide patient material. Methods Patients (n=49 564) registered in the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease registry between 2011 and 2018, diagnosed with a first acute MI, discharged alive and with no previous heart failure, were stratified by degree of LV systolic dysfunction. Results Compared with patients with normal ejection fraction (EF≥50%), patients with a reduced EF (<30%) more often experienced shortness of breath (32.3% vs 5.6%, adjusted OR (95% CI): 7.45 (6.22 to 8.92)), had more often been readmitted (48.1% vs 31.2%, 1.87 (1.61 to 2.19)) and were more often on sick leave (26.6% vs 9.5%, 3.35 (2.45 to 4.58)), whereas there were no significant differences regarding chest pain and quality of life at the follow-up visit after 11–13 months. Patients with EF <30% had participated in education programme (44.9% vs 55.5%, 0.70 (0.60 to 0.81)) and physical therapy (11.3% vs 14.9%, 0.68 (0.58 to 0.79)) and have been physically active at least 30 min per day for at least 5 days per week (35.5% vs 40.2%, 0.86 (0.73 to 1.01)) to a lesser extent. Conclusion Contemporary representative data show that LV systolic dysfunction after MI is associated with a very high symptom burden and worse secondary prevention after 11–13 months.
Hamilton et al. (Thu,) conducted a observational in Left ventricular systolic dysfunction after acute myocardial infarction (n=49,654). LV systolic dysfunction after myocardial infarction is associated with higher rates of dyspnoea and readmission.