Among patients with acute coronary syndrome, every 5% reduction in in-hospital left ventricular ejection fraction was associated with an increased hazard of 1-year mortality or heart failure hospitalization (HR 1.26).
Cohort (n=445)
Yes
Does lower in-hospital LVEF predict 1-year mortality or hospitalization for heart failure in patients with acute coronary syndromes?
Lower in-hospital LVEF is a strong predictor of 1-year mortality or heart failure hospitalization in patients with acute coronary syndrome, regardless of whether it is measured by echocardiography or left ventriculography.
Effect estimate: HR 1.26 (95% CI 1.15-1.38)
p-value: p=<0.001
BACKGROUND: 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. METHODS: We performed a retrospective analysis of 445 participants in the IMMEDIATE Trial who had LVEF measured by left ventriculography or echocardiogram during hospitalization. RESULTS: 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 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). CONCLUSIONS: 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.
Mukherjee et al. (Tue,) conducted a cohort in Acute coronary syndrome (n=445). Lower in-hospital left ventricular ejection fraction (LVEF) vs. Higher LVEF was evaluated on Composite of all-cause mortality or hospitalization for heart failure at 1 year (HR 1.26, 95% CI 1.15-1.38, p=<0.001). Among patients with acute coronary syndrome, every 5% reduction in in-hospital left ventricular ejection fraction was associated with an increased hazard of 1-year mortality or heart failure hospitalization (HR 1.26).