Key result
Initially preserved LVEF in ACS patients rarely deteriorates to <35%, affecting only 1.1%.
Why the study?
Guidelines recommend assessing LVEF in ACS, but many patients undergo multiple assessments and the clinical value of this practice is unknown.
Does routine reassessment of LVEF identify significant deterioration in patients with acute coronary syndromes?
Population
8327 patients with ACS undergoing cardiac catheterization
Comparison
Baseline LVEF > 50% vs 35% to 50% vs < 35%
Design
Cohort study
Follow-up
Average of 2.71 ± 1.31 years
Authors
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Supports limiting routine LVEF reassessment after ACS with preserved or mildly reduced EF; leaves open optimal selective strategies in prospective trials.
Cohort (n=8,327)
Does routine reassessment of LVEF identify significant deterioration in patients with acute coronary syndromes?
Absolute Event Rate: 1.1% vs 5.1%
Routine reassessment of LV function in ACS patients with initially preserved or mildly reduced EF rarely shows deterioration to severely reduced EF, suggesting potential for reducing low-value testing.
Malebranche et al. (2021) conducted a cohort in acute coronary syndromes (n=8,327). Initial left-ventricular ejection fraction (LVEF) was evaluated on deterioration to an LVEF < 35%. Among patients with acute coronary syndromes, only 1.1% of those with initially preserved LVEF (>50%) and 5.1% with LVEF 35-50% deteriorated to an LVEF <35% over an average of 2.71 years.
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