Predictors of Recovery of Left Ventricular Systolic Dysfunction after Acute Myocardial Infarction: From the Korean Acute Myocardial Infarction Registry and Korean Myocardial Infarction Registry

Oh, Pyung Chun; Choi, In Suck; Ahn, Taehoon; Moon, Jeonggeun; Park, Yeonjeong; Seo, Jong Goo; Suh, Soon Yong; Ahn, Youngkeun; Jeong, Myung Ho

doi:10.4070/kcj.2013.43.8.527

Cited by 33 publications

(32 citation statements)

References 22 publications

(26 reference statements)

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“…Peak troponin and CK-MB could significantly predict LV functional recovery at 6 months. This finding support previous findings that peak troponin level strongly predicts the recovery of LV function even more important than any other clinical measure (49,50).…”

Section: Prediction Of Reverse Remodeling At 6 Monthssupporting

confidence: 91%

Prognostic Value of Circumflex Artery Motion as a Measurement of Left Ventricular Long-Axis Systolic Function in Patients Treated With Percutaneous Coronary Intervention

Ammar

Al-Daydamony

Tahlawi

et al. 2015

Zagazig University Medical Journal

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Background: Accurate assessment of LV systolic function during primary PCI can help to optimize reperfusion strategies and has many prognostic implications. Circumflex artery motion (CAM) can be measured during primary PCI to reflect LV long-axis function which is an accurate indicator of LV systolic function. Aim of the work: to test the validity of CAM as a measurement of LV long-axis systolic function in anterior STEMI patients treated with primary PCI and to determine its prognostic value. Patients and Methods: CAM was measured using coronary angiography during primary PCI in 50 STEMI patients. Echocardioghraphic (M-mode, tissue Doppler and speckle-tracking) assessment of LV long-axis systolic function was performed within 24 hours after primary PCI. Follow-up echocardiography was scheduled after 6 months. Reverse remodeling was defined as a reduction >10% in LV end-systolic volume by the end of follow-up period. Results: Strong correlation was found between CAM and echocardiographic parameters of LV long-axis systolic function (p for each < 0.001) as well as LVEF (r= 0.845, p< 0.001) 24 hours after successful primary PCI. Patients were dichotomized according to the median value of CAM (median CAM: 13.9 mm). Supra-median CAM was associated with higher LVEF (56.0±7.4 vs. 42.6±3.6, p<0.001), lower peak troponin (6.43±2.6 vs. 11.13±2.78 ug/L, p<0.001) and lower incidence of composite major adverse cardiac events (3.8% vs. 45.8%, p=0.001). A CAM cutoff value of 10.8 mm (sensitivity 96% and specificity 100%) accurately predicted reverse remodeling at 6 months. Conclusion: CAM measured at the time of primary PCI can predict LV systolic function loss, adverse clinical outcome and reverse remodeling in STEMI patients. Thus it can gauge the choice of reperfusion strategy and adjunctive therapy.

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Section: Prediction Of Reverse Remodeling At 6 Monthssupporting

confidence: 91%

Prognostic Value of Circumflex Artery Motion as a Measurement of Left Ventricular Long-Axis Systolic Function in Patients Treated With Percutaneous Coronary Intervention

Ammar

Al-Daydamony

Tahlawi

et al. 2015

Zagazig University Medical Journal

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“…Systolic function and troponin levels at the time of MI have been shown to have strong associations with subsequent functional recovery (4,6,11). Prior studies have reported an association between BNP elevation and adverse remodeling at 4 months (increase in LV end-diastolic volume by 20%), a finding not repeated in our study (12,13).…”

Section: Discussionmentioning

confidence: 99%

Predicting Persistent Left Ventricular Dysfunction Following Myocardial Infarction

Brooks

Lee

Rao

et al. 2016

Journal of the American College of Cardiology

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BACKGROUND Persistent severe left ventricular (LV) systolic dysfunction after myocardial infarction (MI) is associated with increased mortality and is a class I indication for implantation of a cardioverter-defibrillator. OBJECTIVES We developed models and assessed independent predictors of LV recovery to >35% and ≥50% after 90-day follow-up in patients presenting with acute MI and severe LV dysfunction.. METHODS Our multicenter prospective observational study enrolled participants with ejection fraction (EF) of ≤35% at the time of MI (n = 231). Predictors for EF recovery to >35% and ≥50% were identified after multivariate modeling and validated in a separate cohort (n = 236). RESULTS In PREDICTS, 43% of patients had persistent EF ≤35%, 31% had an EF of 36% to 49%, and 26% had an EF ≥50%. The model that best predicted recovery of EF to >35%, included EF at presentation, length of stay, prior MI, lateral wall motion abnormality at presentation, and peak troponin. The model that best predicted recovery of EF to ≥50%, included EF at presentation, peak troponin, prior MI, and presentation with ventricular fibrillation or cardiac arrest. After predictors were transformed into point scores, the lowest point scores predicted a 9% and 4% probability of EF recovery to >35% and ≥50%, respectively, whereas profiles with the highest point scores predicted an 87% and 49% probability of EF recovery to >35% and ≥50%. CONCLUSIONS In patients with severe systolic dysfunction following acute MI with an EF ≤35%, 57% had EF recovery to >35%. A model using clinical variables present at the time of MI can help predict EF recovery.

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“…[15][16][17] This registry was sponsored by the Korean Society of Cardiology and managed by the Korean working group of AMI. Participating centers are mainly academic centers with high volumes of patients, facilities for primary PCI, and on-site cardiac surgery.…”

Section: Study Populationmentioning

confidence: 99%

Persistent Renal Dysfunction After Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

et al. 2016

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We determined the incidence, predictors, and outcomes of persistent renal dysfunction (PRD) following percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Among 16 264 patients enrolled in a nationwide registry, we studied patients with AMI who had their estimated glomerular filtration rate at baseline and 1 month later (n = 3606). We used multivariate regression and propensity score (PS)-matched Cox proportional hazards to evaluate the association between PRD and outcomes. Persistent renal dysfunction occurred in 1333 (37%) patients. Significant PRD contributors included old age, low body mass index (BMI), hypertension, Killip class, and the extent of vessel disease. Persistent renal dysfunction was associated with an increased 1-year major adverse cardiac events (all-cause death, myocardial infarction, or revascularization) relative to no-PRD (entire cohort: 6.2% vs 4.5%, hazard ratio[HR] 1.63, 95% confidence interval [CI] 1.18-2.25, P = .003; PS-matched cohort: 7.2% vs 4.9%, HR 1.67, 95% CI 1.08-2.58, P = .022). In conclusion, PRD occurred in approximately one-third of patients with AMI following PCI. It was associated with old age, hypertension, low BMI, initial hemodynamic instability, and extent of vessel disease and was a predictor of worse outcomes at 1 year.

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Predictors of Recovery of Left Ventricular Systolic Dysfunction after Acute Myocardial Infarction: From the Korean Acute Myocardial Infarction Registry and Korean Myocardial Infarction Registry

Cited by 33 publications

References 22 publications

Prognostic Value of Circumflex Artery Motion as a Measurement of Left Ventricular Long-Axis Systolic Function in Patients Treated With Percutaneous Coronary Intervention

Prognostic Value of Circumflex Artery Motion as a Measurement of Left Ventricular Long-Axis Systolic Function in Patients Treated With Percutaneous Coronary Intervention

Predicting Persistent Left Ventricular Dysfunction Following Myocardial Infarction

Persistent Renal Dysfunction After Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

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