Trends in long-term prognosis according to left ventricular ejection fraction after acute coronary syndrome

Yahud, Ella; Tzuman, Oran; Fink, Noam; Goldenberg, Ilan; Goldkorn, Ronen; Peled, Yael; Lev, Eli I.; Asher, Elad

doi:10.1016/j.jjcc.2020.03.012

Cited by 10 publications

(9 citation statements)

References 25 publications

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“…LVEF is a quantitative marker to evaluate cardiac systolic function. previous study showed that patients with preserved left ventricular ejection fraction had lower one and 3-year mortality rates as compared with reduced left ventricular ejection fraction regardless of the acute coronary syndrome period onset (Yahud et al, 2020). Our results showed that GF for therapeutic angiogenesis could increase LVEF by 2.05%.…”

Section: Discussionsupporting

confidence: 57%

Growth factor for therapeutic angiogenesis in ischemic heart disease: A meta-analysis of randomized controlled trials

Tan

Long

et al. 2022

Front. Cell Dev. Biol.

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Aim: This study was designed to systematically evaluate the effects of growth factor (GF) for therapeutic angiogenesis on ischemic heart disease (IHD) by pooling the results of randomized controlled trials (RCTs).Methods and Results: PubMed, EMBASE, and CENTRAL databases were searched from inception to October 2022. RCTs, investigating the effects of GF therapy on IHD, were included. The risk bias of included study was assessed according to Cochrane tool. Weighted mean difference (WMD), calculated with fixed effect model or random effect model, was used to evaluate the effects of GF therapy on left ventricular ejection fraction (LVEF) and Canadian Cardiovascular Society (CCS) angina class. Relative risk (RR) was used to evaluate the effects of GF therapy on all-cause mortality, major adverse cardiovascular events (MACE) and revascularization. Meta-analysis, meta-regression analysis and publication bias analysis were performed by RevMan 5.3 or Stata 15.1 software. Twenty-nine studies involving 2899 IHD patients (1,577 patients in GF group and 1,322 patients in control group) were included. Compared with the control group, GF therapy did not reduce all-cause mortality (RR: 0.82; 95% CI: 0.54–1.24; p = 0.341), MACE [(RR: 0.83; 95% CI: 0.61–1.12; p = 0.227), revascularization (RR: 1.27, 95% CI: 0.82–1.96, p = 0.290) and CCS angina class (WMD: −0.08, 95% CI: −0.36 to 0.20, p = 0.560). However, GF therapy could increase LVEF during short-term follow-up (<1 year).Conclusion: GF for therapeutic angiogenesis was beneficial for increasing LVEF during short-term follow-up (<1 year), however, the therapy was not efficacious in decreasing all-cause mortality, MACE and revascularization.

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Section: Discussionsupporting

confidence: 57%

Growth factor for therapeutic angiogenesis in ischemic heart disease: A meta-analysis of randomized controlled trials

Tan

Long

et al. 2022

Front. Cell Dev. Biol.

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“…LVEF not only reflects the pumping function of the heart but also has predictive value for prognosis [2,3]. In this study, at the follow-up, the LVEF of the patients had significantly increased, from 28.4 ± 5.3% to 34.7 ± 5.9%.…”

Section: Discussionmentioning

confidence: 52%

Dapagliflozin in Heart Failure with Reduced Ejection Fraction: A Real-World Study

Zhang

2022

CVIA

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Aims: We aimed to observe the improvements in cardiac function indexes and the occurrence of adverse events in patients with heart failure with reduced ejection fraction (HFrEF) after dapagliflozin administration in a real-world setting.Methods: We retrospectively enrolled 201 patients with HFrEF who were treated at a tertiary hospital in Zhengzhou and started to take dapagliflozin (10 mg/d) from March 2020 to June 2021. Their New York Heart Association (NYHA) functional class, cardiac ultrasound indexes, laboratory indexes, and vital signs between baseline and the last follow-up visit were compared, and their adverse events during the follow-up period were recorded.Results: The follow-up period was 173 (67–210) days. The cardiac function indexes of patients at follow-up, compared with baseline, indicated significant improvement (proportion of NYHA functional class I and II: 40.8% vs. 56.2%; left ventricular ejection fraction: 28.4 ± 5.3% vs. 34.7 ± 5.9%; left ventricular end-diastolic diameter: 70.1 ± 6.4 mm vs. 64.7 ± 5.6 mm; N-terminal pro-B-type natriuretic peptide: 5421.9 ± 2864.4 pg/mL vs. 2842.8 ± 1703.4 pg/mL at baseline vs. at follow-up; all P < 0.05). The rates of hypotension, deterioration of renal function, and genital infection during the follow-up period were 6.5%, 4.0%, and 3.5%, respectively.Conclusions: We believe that dapagliflozin is safe and effective in patients with HFrEF in the real world.

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“…21 However, this new categorization has not been widely evaluated after ACS. [22][23][24] In a single-centre study from Israel, investigators have observed higher mortality among patients with STEMI (n = 2086) undergoing primary percutaneous coronary intervention (PCI) who had mildly reduced EF, as compared with normal EF. 9 Similarly, in another single-centre retrospective cohort study from Northern Ireland (n = 533), mildly reduced EF after STEMI was associated with higher composite outcome of death, hospitalization for HF, or ventricular arrhythmias, compared with patients with normal EF.…”

Section: Discussionmentioning

confidence: 99%

Long‐term mortality after acute coronary syndromes among patients with normal, mildly reduced, or reduced ejection fraction

et al. 2022

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Aims Left ventricular ejection fraction (LVEF) ≤ 40% is a well-established risk factor for mortality after acute coronary syndromes (ACS). However, the long-term prognostic impact of mildly reduced ejection fraction (EF) (LVEF 41-49%) after ACS remains less clear. Methods and resultsThis was a retrospective study enrolling patients admitted with ACS included in a single-centre databank. LVEF was assessed by echocardiography during index hospitalization. Patients were divided in the following categories according to LVEF: normal (LVEF ≥ 50%), mildly reduced (LVEF 41-49%), and reduced (LVEF ≤ 40%). The endpoint of interest was all-cause death after hospital discharge. A multivariable Cox model was used to adjust for confounders. A total of 3200 patients were included (1952 with normal EF, 375 with mildly reduced EF, and 873 with reduced EF). The estimated cumulative incidence rates of mortality at 10 years for patients with normal, mildly reduced, and reduced EF were 24.8%, 33.5%, and 41.3%, respectively. After adjustments, the presence of reduced EF was associated with higher mortality compared with normal EF [adjusted hazard ratio (HR) 1.64; 95% confidence interval (CI) 1.36-1.96; P < 0.001], as was mildly reduced EF compared with normal EF (adjusted HR 1.33; 95% CI 1.05-1.68; P = 0.019). The presence of reduced EF was not associated with a statistically significantly higher mortality compared with mildly reduced EF (adjusted HR 1.23; 95% CI 0.96-1.57; P = 0.095). Conclusions In patients with ACS, mildly reduced EF measured in the acute phase was associated with higher long-term mortality compared with patients with normal EF. These data emphasize the importance of anti-remodelling therapies for ACS patients who have LVEF in the mildly reduced range.

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Trends in long-term prognosis according to left ventricular ejection fraction after acute coronary syndrome

Cited by 10 publications

References 25 publications

Growth factor for therapeutic angiogenesis in ischemic heart disease: A meta-analysis of randomized controlled trials

Growth factor for therapeutic angiogenesis in ischemic heart disease: A meta-analysis of randomized controlled trials

Dapagliflozin in Heart Failure with Reduced Ejection Fraction: A Real-World Study

Long‐term mortality after acute coronary syndromes among patients with normal, mildly reduced, or reduced ejection fraction

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