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July 30, 2014Circulation

Post-AMI recovery improves reduced LVEF in ~55% of patients within a month, with minimal further gains.

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Why the study?

Does left ventricular ejection fraction improve sufficiently within 1 month after acute myocardial infarction to remove the indication for an implantable cardioverter-defibrillator?

Population

100 patients admitted for acute myocardial infarction (AMI) with reduced LVEF (≤40%)

Design

Cohort

Follow-up

3 months

Key result

Post-AMI recovery over 1 month resulted in 55% of patients with initial LVEF ≤40% improving their LVEF to >35%, with minimal further improvement (1.9 percentage units) over the next 2 months.

Authors

JSJohanna SjöblomJMJosephine MuhrbeckNWNils Witt

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Overview

Should not yet alter post-AMI ICD timing; leaves open optimal reassessment in prospective trials.

Key Points

  • The study aims to determine how many patients experience improved left ventricular ejection fraction after an acute myocardial infarction.
  • Included 100 patients with reduced left ventricular ejection fraction after acute myocardial infarction.
  • Conducted repeat echocardiographic examinations at 5 days, 1 month, and 3 months post-AMI.
  • Monitored for life-threatening arrhythmias within the first 9 weeks.
  • At 1 month, 55% of patients had an ejection fraction greater than 35%.
  • Mean LVEF improvement was small (1.9 percentage units) between 1 and 3 months.
  • 10% of patients experienced life-threatening arrhythmias during the first 9 weeks.

Study Design

Type

Cohort (n=100)

Structured PICO

Does left ventricular ejection fraction improve sufficiently within 1 month after acute myocardial infarction to remove the indication for an implantable cardioverter-defibrillator?

P
Population
100 patients admitted for acute myocardial infarction (AMI) with reduced LVEF (≤40%)
I
Intervention
Echocardiographic monitoring of LVEF evolution at 5 days, 1 month, and 3 months post-AMI
O
Outcome
Proportion of patients with improved LV function (LVEF >35%) at 1 monthsurrogate

The majority of LVEF improvement after AMI occurs within the first month, suggesting that waiting beyond this period for ICD implantation may not be necessary and leaves patients exposed to a high risk of life-threatening arrhythmias.

Cite This Study

Sjöblom et al. (2014) conducted a cohort in Acute Myocardial Infarction with reduced LVEF (n=100). Echocardiographic follow-up was evaluated on Proportion of patients with LVEF >35%. Post-AMI recovery over 1 month resulted in 55% of patients with initial LVEF ≤40% improving their LVEF to >35%, with minimal further improvement (1.9 percentage units) over the next 2 months.

synapsesocial.com/papers/6a07e298416812afca06e5dfhttps://doi.org/10.1161/circulationaha.114.009924
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