July 10, 2026Journal of the American College of Cardiology
The relationships of left ventricular ejection fraction, end-systolic volume index and infarct size to six-month mortality after hospital discharge following myocardial infarction treated by thrombolysis
Key result
LVEF predicts six-month mortality better than end-systolic volume index or infarct size after MI thrombolysis.
- P<0.0001
- n=2,948
Why the study?
Left ventricular ejection fraction, end-systolic volume index, and infarct size had never been compared as prognostic indicators in the same study group after myocardial infarction treated with thrombolysis.
Population
Patients after myocardial infarction treated with thrombolysis enrolled in the CORE trial
Comparison
Prognostic association of EF vs ESVI vs IS
Design
Randomized trial substudy
Authors
Discussion
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Member takes
Implication
EF assessment aids post-MI risk stratification; leaves open whether EF-guided therapies improve survival beyond current care.
Key Points
- This research aims to assess the predictive value of left ventricular ejection fraction, end-systolic volume index, and infarct size for six-month mortality post-myocardial infarction.
- Analyzed data from 2,948 patients in the CORE trial.
- Measured left ventricular ejection fraction, end-systolic volume index, and infarct size using radionuclide techniques.
- Correlated these measures with six-month mortality outcomes.
- Ejection fraction significantly predicted mortality (p < 0.0001).
- Infarct size also significantly predicted mortality (p = 0.03), while end-systolic volume index showed a trend (p = 0.055).
- Ejection fraction (EF < 30%) was linked to an 11% mortality rate among 95 patients.
Study Design
Type
RCT (n=2,948)
PICO
P
Population
2,948 patients with myocardial infarction treated with thrombolysis, of whom up to 1,194 underwent radionuclide measurements to evaluate prognostic indicators for six-month mortality.
I
Intervention / Comparator
Left ventricular ejection fraction (EF), end-systolic volume index (ESVI) and infarct size (IS)
O
Primary Outcome
Six-month mortality, p=<0.0001
Main Result
p-value: p=<0.0001
Limitations
- Limited power to detect independent significance of ESVI or IS.
Cite This Study
Burns et al. (2002) conducted an RCT in Myocardial infarction (n=2,948). Left ventricular ejection fraction (EF), end-systolic volume index (ESVI) and infarct size (IS) was evaluated on Six-month mortality (p=<0.0001). Left ventricular ejection fraction (EF) was a stronger predictor of six-month mortality than end-systolic volume index or infarct size in patients treated with thrombolysis for myocardial infarction (p=0.001).