Background: A reduced left ventricular ejection fraction (LVEF) ≤35% ≥6 weeks following an acute myocardial infarction (MI) may indicate prophylactic implantation of a cardioverter-defibrillator (ICD). We sought to find predictors of absence of significant left ventricular (LV) remodeling post-MI.
Methods: All consecutive patients hospitalized for acute MI with an LVEF ≤35% at discharge in our institution from 2010 were retrospectively included. Patients were assigned to two groups according to the persistence of an LVEF ≤35% (ICD+) or a recovery >35% (ICD-). Logistic regression was performed to build a predictive score, which was then externally validated.
Results: Among a total of 1533 consecutive MI patients, 150 met inclusion criteria, 53 (35%) in the ICD+ group and 97 in the ICD group. After multivariable analyses, an LVEF ≤25% at discharge (adjusted OR 6.23 [2.47 to 17.0], p < .0001) and a CPK peak at the MI acute phase >4600 UI/L (adjusted OR 9.99 [4.27 to 25.3], p < .0001) both independently predicted non-recovery at 6 weeks. The IC-D (Increased Cpk-LV Dysfunction) score predicted persistent LVEF ≤35% with areas under curve of 0.83 and 0.73, in the study population and in a multicenter validation cohort of 150 patients, respectively (p < .0001).
Conclusions: The association of a severely reduced LVEF and a major release of myocardial necrosis biomarkers at the acute phase of MI predict unfavorable remodeling, and prophylactic ICD implantation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/pace.14244 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A long-term clinical comparative study of left bundle branch pacing versus biventricular pacing in patients with heart failure and complete left bundle branch block.
Heart Vessels
January 2025
Department of Cardiology, Fujian Medical University Union Hospital, Fujian Institute of Coronary Heart Disease, Fujian Heart Medical Center, Fuzhou, 350001, Fujian, China.
Left bundle branch pacing (LBBP) is an emerging physiological pacing technique characterized by stable pacing parameters and a narrower QRS duration. This study aims to compare the long-term efficacy and safety of biventricular pacing (BIVP) and LBBP in patients with heart failure with reduced ejection fraction (HFrEF) and complete left bundle branch block (CLBBB). A retrospective analysis was conducted on 35 patients with chronic HFrEF accompanied by CLBBB treated at our center from April 2018 to October 2022.
View Article and Find Full Text PDFBasic Science and Pathogenesis.
Alzheimers Dement
December 2024
Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Background: Sodium glucose transporter 2 inhibitor (SGLT2i) is the latest guideline-directed medical therapy for patients with heart failure, as it has demonstrated favorable cardiovascular outcomes in heart failure (HF) patients with or without diabetes. Furthermore, SGLT2i has effectively improved cognitive function in older adults with diabetes and HF. However, the effects of SGLT2i on cognitive function and brain mitochondrial function in rats with ischemic HF have never been investigated.
View Article and Find Full Text PDFSex differences and clinical outcomes, including ventricular tachyarrhythmias, of patients with heart failure with reduced ejection fraction treated with sacubitril/valsartan.
Front Cardiovasc Med
December 2024
Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
Background: Women with heart failure with reduced ejection fraction (HFrEF) often experience worse clinical outcomes compared to men, including higher rates of mortality, hospitalization, and congestion. However, the effects of sacubitril/valsartan on these outcomes, as well as on ventricular tachyarrhythmias, have not been well studied in women with HFrEF.
Methods: This study included consecutive series of patients treated with sacubitril/valsartan at University Hospital Mannheim from 2016 to 2020.
Construction of Clinical Predictive Models for Heart Failure Detection Using Six Different Machine Learning Algorithms: Identification of Key Clinical Prognostic Features.
Int J Gen Med
December 2024
Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, People's Republic of China.
Purpose: Heart failure (HF) is a clinical syndrome in which structural or functional abnormalities of the heart result in impaired ventricular filling or ejection capacity. In order to improve the adaptability of models to different patient populations and data situations. This study aims to develop predictive models for HF risk using six machine learning algorithms, providing valuable insights into the early assessment and recognition of HF by clinical features.
View Article and Find Full Text PDFCross-Sectional Analyses to Assess the Clinical Safety and Effectiveness of Bisoprolol in Patients With Non-obstructive Coronary Artery Disease Who Underwent Percutaneous Coronary Intervention: A Post-hoc Analysis.
Cureus
December 2024
Medical Strategic Affairs, Torrent Pharmaceuticals Ltd., Ahmedabad, IND.
Introduction: Elevated central aortic pressure, cardiac output and peripheral vascular resistance contribute to high morbidity in relation to end organ dysfunction in obstructive and non-obstructive coronary artery disease (NOCAD) cases despite revascularization. Bisoprolol preempts further progression of left ventricular dysfunction in such cases due to anti-ischemic and anti-hypertensive effects, further extending its evaluation in local Indian settings.
Methods: Post-hoc analyses of NOCAD patients with epicardial stenosis (N=378, 30 to 70% stenosis) from cross-sectional analyses conducted across eighty centers in India.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!