Different prognostic impact of systolic function in patients with heart failure and/or acute myocardial infarction

TY - JOUR

T1 - Different prognostic impact of systolic function in patients with heart failure and/or acute myocardial infarction

AU - Thune, Jens Jakob

AU - Carlsen, Christian

AU - Buch, Pernille

AU - Seibaek, Marie

AU - Burchardt, Hans

AU - Torp-Pedersen, Christian

AU - Køber, Lars

AU - DIAMOND investigators

N1 - Keywords: Aged; Comorbidity; Heart Failure; Humans; Life Tables; Male; Middle Aged; Myocardial Infarction; Prognosis; Proportional Hazards Models; Stroke Volume; Systole

PY - 2005

Y1 - 2005

N2 - AIMS: To study the prognostic importance of left ventricular systolic function in patients with heart failure (HF) and acute myocardial infarction (AMI) with respect to the presence of prior heart failure and known ischemic heart disease. METHODS: In 13,084 consecutive patients diagnosed with either AMI or HF, a medical history and an echocardiographic assessment of left ventricular systolic function by wall motion index (WMI) were obtained. Patients were divided into four groups: AMI with or without a history of HF, and primary HF (no recent AMI) with or without a history of ischemic heart disease (IHD). Mortality was assessed after nine years of follow-up. RESULTS: WMI stratified patients according to all-cause mortality in all four groups of patients (p<0.0001). For a decrease in WMI of 0.3 (corresponding to a decrease in left ventricular ejection fraction of 0.1), the hazard ratio was 1.61 (95% CI: 1.48-1.76) for AMI patients without prior HF, 1.43 (1.38-1.48) for AMI patients with prior HF, 1.26 (1.22-1.30) for primary HF patients with IHD and 1.23 (1.18-1.27) for HF patients without IHD. CONCLUSION: WMI stratifies patients with IHD and/or HF according to risk of all-cause death. The presence of HF attenuates the prognostic power of WMI.

AB - AIMS: To study the prognostic importance of left ventricular systolic function in patients with heart failure (HF) and acute myocardial infarction (AMI) with respect to the presence of prior heart failure and known ischemic heart disease. METHODS: In 13,084 consecutive patients diagnosed with either AMI or HF, a medical history and an echocardiographic assessment of left ventricular systolic function by wall motion index (WMI) were obtained. Patients were divided into four groups: AMI with or without a history of HF, and primary HF (no recent AMI) with or without a history of ischemic heart disease (IHD). Mortality was assessed after nine years of follow-up. RESULTS: WMI stratified patients according to all-cause mortality in all four groups of patients (p<0.0001). For a decrease in WMI of 0.3 (corresponding to a decrease in left ventricular ejection fraction of 0.1), the hazard ratio was 1.61 (95% CI: 1.48-1.76) for AMI patients without prior HF, 1.43 (1.38-1.48) for AMI patients with prior HF, 1.26 (1.22-1.30) for primary HF patients with IHD and 1.23 (1.18-1.27) for HF patients without IHD. CONCLUSION: WMI stratifies patients with IHD and/or HF according to risk of all-cause death. The presence of HF attenuates the prognostic power of WMI.

U2 - 10.1016/j.ejheart.2005.01.019

DO - 10.1016/j.ejheart.2005.01.019

M3 - Journal article

C2 - 15923139

SN - 1567-4215

VL - 7

SP - 852

EP - 858

JO - European Journal of Heart Failure, Supplement

JF - European Journal of Heart Failure, Supplement

IS - 5

ER -