What question did this study set out to answer?

To examine how neurohumoral activation evolves over two years in post-myocardial infarction patients and its significance for prognosis.

October 1, 1998European Heart JournalOpen Access

Two-year time course and significance of neurohumoral activation in the Survival and Ventricular Enlargement (SAVE) Study

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Why the study?

Do neurohormone levels predict the development of severe heart failure or combined cardiovascular endpoints in asymptomatic survivors of myocardial infarction with LVEF <= 40%?

Population

534 survivors of myocardial infarction with left ventricular ejection fraction <= 40% early post-infarction…

Design

Cohort

Follow-up

38 +/- 7 months

Authors

PVPascal VantrimpontMontreal Heart Institute

Discussion

Member takes

Implication

3-month ANP may flag higher HF risk post-MI with LVEF ≤40%; leaves open whether serial monitoring improves outcomes.

Key Points

To examine how neurohumoral activation evolves over two years in post-myocardial infarction patients and its significance for prognosis.
Measured neurohormones at baseline, 3, 12, and 24 months post-infarction in patients (n=534) with left ventricular ejection fraction ≤40%.
Followed patients for an average of 38 months to assess prognostic factors related to neurohormonal levels.
Conducted multivariate analyses to identify relationships between neurohormones and adverse events.
Atrial natriuretic peptide levels at 3 months were significantly associated with severe heart failure (P < 0.001) and combined endpoints (P = 0.022).
Activation of norepinephrine prior to recurrent myocardial infarction was linked with significant risks (P < 0.001).
Neurohumoral activation decreased in low-risk patients, but those with elevated neurohormone levels showed a correlative risk with adverse outcomes.

Structured PICO

Do neurohormone levels predict the development of severe heart failure or combined cardiovascular endpoints in asymptomatic survivors of myocardial infarction with LVEF <= 40%?

Population

534 survivors of myocardial infarction with left ventricular ejection fraction <= 40% early post-infarction who are initially asymptomatic

Intervention

Measurement of neurohormones (atrial natriuretic peptide, aldosterone, norepinephrine, plasma renin activity) at baseline, 3, 12, and 24 months post-infarction

Outcome

Development of severe heart failure or combined end-points (cardiovascular death, myocardial infarction, or severe heart failure)composite

In asymptomatic post-MI patients with LVEF <= 40%, elevated levels of atrial natriuretic peptide and aldosterone at 3 months are closely associated with the development of severe heart failure and adverse cardiovascular events.

Cite This Study

Pascal Vantrimpont (1998) studied this question.

synapsesocial.com/papers/6a22c072d5ef0a743714e4ea https://doi.org/10.1053/euhj.1998.1093

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Two-year time course and significance of neurohumoral activation in the Survival and Ventricular Enlargement (SAVE) Study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Two-year time course and significance of neurohumoral activation in the Survival and Ventricular Enlargement (SAVE) Study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider