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Prognostic factors affecting the all-cause death and sudden cardiac death rates of post myocardial infarction patients with low left ventricular ejection fraction.
Chin Med J (Engl). 2009 Apr 05; 122(7):802-6.CM

Abstract

BACKGROUND

Post myocardial infarction (post-MI) patients with low left ventricular ejection fraction (LVEF) have been candidates for an implantable cardioverter-defibrillator (ICD) since the Multicenter Automatic Defibrillator Implantation Trail II (MADIT II). However, due to the high costs of ICDs, widespread usage has not been accepted. Therefore, further risk stratification for post-MI patients with low LVEF may aid in the selection of patients that will benefit most from ICD treatment.

METHODS

Four hundred and seventeen post-MI patients with low LVEF (< or = 35%) were enrolled in the study. All the patients received standard examination and proper treatment and were followed up to observe the all-cause death rate and sudden cardiac death (SCD) rate. Then COX proportional-hazards regression model was used to investigate the clinical factors which affect the all-cause death rate and SCD rate.

RESULTS

Of 55 patients who died during (32 +/- 24) months of follow-up, 37 (67%) died suddenly. After adjusting for baseline clinical characteristics, multivariate COX proportional-hazards regression model identified the following variables associated with death from all causes: New York Heart Association (NYHA) heart failure class > or = III (Hazard ratio: 2.361), LVEF < or = 20% (Hazard ratio: 2.514), sustained ventricular tachycardia (Hazard ratio: 6.453), and age > or = 70 years (Hazard ratio: 3.116). The presence of sustained ventricular tachycardia (Hazard ratio: 6.491) and age > or = 70 years (Hazard ratio: 2.694) were specifically associated with SCD.

CONCLUSIONS

In the post-MI patients with low LVEF, factors as LVEF < or = 20%, age > or = 70 years, presence of ventricular tachycardia, and NYHA heart failure class > or = III predict an adverse outcome. The presence of sustained ventricular tachycardia and age > or = 70 years was associated with occurrence of SCD in these patients.

Authors+Show Affiliations

Center for Arrhythmia Diagnosis and Treatment, Fu Wai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

19493393

Citation

Dai, Shi-Mo, et al. "Prognostic Factors Affecting the All-cause Death and Sudden Cardiac Death Rates of Post Myocardial Infarction Patients With Low Left Ventricular Ejection Fraction." Chinese Medical Journal, vol. 122, no. 7, 2009, pp. 802-6.
Dai SM, Zhang S, Chen KP, et al. Prognostic factors affecting the all-cause death and sudden cardiac death rates of post myocardial infarction patients with low left ventricular ejection fraction. Chin Med J (Engl). 2009;122(7):802-6.
Dai, S. M., Zhang, S., Chen, K. P., Hua, W., Wang, F. Z., & Chen, X. (2009). Prognostic factors affecting the all-cause death and sudden cardiac death rates of post myocardial infarction patients with low left ventricular ejection fraction. Chinese Medical Journal, 122(7), 802-6.
Dai SM, et al. Prognostic Factors Affecting the All-cause Death and Sudden Cardiac Death Rates of Post Myocardial Infarction Patients With Low Left Ventricular Ejection Fraction. Chin Med J (Engl). 2009 Apr 5;122(7):802-6. PubMed PMID: 19493393.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic factors affecting the all-cause death and sudden cardiac death rates of post myocardial infarction patients with low left ventricular ejection fraction. AU - Dai,Shi-Mo, AU - Zhang,Shu, AU - Chen,Ke-Ping, AU - Hua,Wei, AU - Wang,Fang-Zheng, AU - Chen,Xin, PY - 2009/6/5/entrez PY - 2009/6/6/pubmed PY - 2009/10/7/medline SP - 802 EP - 6 JF - Chinese medical journal JO - Chin Med J (Engl) VL - 122 IS - 7 N2 - BACKGROUND: Post myocardial infarction (post-MI) patients with low left ventricular ejection fraction (LVEF) have been candidates for an implantable cardioverter-defibrillator (ICD) since the Multicenter Automatic Defibrillator Implantation Trail II (MADIT II). However, due to the high costs of ICDs, widespread usage has not been accepted. Therefore, further risk stratification for post-MI patients with low LVEF may aid in the selection of patients that will benefit most from ICD treatment. METHODS: Four hundred and seventeen post-MI patients with low LVEF (< or = 35%) were enrolled in the study. All the patients received standard examination and proper treatment and were followed up to observe the all-cause death rate and sudden cardiac death (SCD) rate. Then COX proportional-hazards regression model was used to investigate the clinical factors which affect the all-cause death rate and SCD rate. RESULTS: Of 55 patients who died during (32 +/- 24) months of follow-up, 37 (67%) died suddenly. After adjusting for baseline clinical characteristics, multivariate COX proportional-hazards regression model identified the following variables associated with death from all causes: New York Heart Association (NYHA) heart failure class > or = III (Hazard ratio: 2.361), LVEF < or = 20% (Hazard ratio: 2.514), sustained ventricular tachycardia (Hazard ratio: 6.453), and age > or = 70 years (Hazard ratio: 3.116). The presence of sustained ventricular tachycardia (Hazard ratio: 6.491) and age > or = 70 years (Hazard ratio: 2.694) were specifically associated with SCD. CONCLUSIONS: In the post-MI patients with low LVEF, factors as LVEF < or = 20%, age > or = 70 years, presence of ventricular tachycardia, and NYHA heart failure class > or = III predict an adverse outcome. The presence of sustained ventricular tachycardia and age > or = 70 years was associated with occurrence of SCD in these patients. SN - 2542-5641 UR - https://www.unboundmedicine.com/medline/citation/19493393/Prognostic_factors_affecting_the_all_cause_death_and_sudden_cardiac_death_rates_of_post_myocardial_infarction_patients_with_low_left_ventricular_ejection_fraction_ L2 - https://Insights.ovid.com/pubmed?pmid=19493393 DB - PRIME DP - Unbound Medicine ER -