TY - JOUR
T1 - An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction
T2 - The VALIANT registry
AU - Velazquez, Eric J.
AU - Francis, Gary S.
AU - Armstrong, Paul W.
AU - Aylward, Phillip E.
AU - Diaz, Rafael
AU - O'Connor, Christopher M.
AU - White, Harvey D.
AU - Henis, Marc
AU - Rittenhouse, Lois M.
AU - Kilaru, Rakhi
AU - Gilst, Wiek Van
AU - Ertl, Georg
AU - Maggioni, Aldo P.
AU - Spac, Jiri
AU - Weaver, W. Douglas
AU - Rouleau, Jean Lucien
AU - McMurray, John J.V.
AU - Pfeffer, Marc A.
AU - Califf, Robert M.
PY - 2004/11/1
Y1 - 2004/11/1
N2 - We analysed the contemporary incidence, outcomes, and predictors of heart failure (HF) and/or left ventricular systolic dysfunction (LVSD) before discharge in patients with acute myocardial infarction (MI). The baseline presence of HF or LVSD, or its development during hospitalisation, increases short- and long-term risk after MI, yet its incidence, predictors, and outcomes have not been well described in a large, international, general MI population. The VALIANT registry included 5573 consecutive MI patients at 84 hospitals in nine countries from 1999 to 2001. A multivariable logistic survival model was constructed using baseline variables to determine the adjusted mortality risk for those with in-hospital HF and/or LVSD. Baseline variables were also tested for associations with in-hospital HF and/or LVSD. Of the 5566 patients analysed, 42% had HF and/or LVSD during hospitalisation. Their in-hospital mortality rate was 13.0% compared with 2.3% for those without HF and/or without LVSD. After adjustment for other baseline risk factors, in-hospital HF and/or LVSD carried a hazard ratio for in-hospital mortality of 4.12 (95% confidence interval: 3.08-5.56). Patients with HF and/or LVSD also had disproportionately higher rates of other cardiovascular events. HF and/or LVSD is common in the general contemporary MI population and precedes 80.3% of all in-hospital deaths after MI. Survivors of early MI-associated HF and/or LVSD have more complications, longer hospitalisations, and are more likely to die during hospitalisation. Although baseline variables can identify MI patients at highest risk for HF and/or LVSD, such patients are less likely to receive indicated procedures and medical therapies.
AB - We analysed the contemporary incidence, outcomes, and predictors of heart failure (HF) and/or left ventricular systolic dysfunction (LVSD) before discharge in patients with acute myocardial infarction (MI). The baseline presence of HF or LVSD, or its development during hospitalisation, increases short- and long-term risk after MI, yet its incidence, predictors, and outcomes have not been well described in a large, international, general MI population. The VALIANT registry included 5573 consecutive MI patients at 84 hospitals in nine countries from 1999 to 2001. A multivariable logistic survival model was constructed using baseline variables to determine the adjusted mortality risk for those with in-hospital HF and/or LVSD. Baseline variables were also tested for associations with in-hospital HF and/or LVSD. Of the 5566 patients analysed, 42% had HF and/or LVSD during hospitalisation. Their in-hospital mortality rate was 13.0% compared with 2.3% for those without HF and/or without LVSD. After adjustment for other baseline risk factors, in-hospital HF and/or LVSD carried a hazard ratio for in-hospital mortality of 4.12 (95% confidence interval: 3.08-5.56). Patients with HF and/or LVSD also had disproportionately higher rates of other cardiovascular events. HF and/or LVSD is common in the general contemporary MI population and precedes 80.3% of all in-hospital deaths after MI. Survivors of early MI-associated HF and/or LVSD have more complications, longer hospitalisations, and are more likely to die during hospitalisation. Although baseline variables can identify MI patients at highest risk for HF and/or LVSD, such patients are less likely to receive indicated procedures and medical therapies.
KW - Heart failure
KW - Killip class
KW - Left ventricular dysfunction
KW - Myocardial infarction
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=7544228503&partnerID=8YFLogxK
U2 - 10.1016/j.ehj.2004.08.006
DO - 10.1016/j.ehj.2004.08.006
M3 - Article
C2 - 15522470
AN - SCOPUS:7544228503
SN - 0195-668X
VL - 25
SP - 1911
EP - 1919
JO - European Heart Journal
JF - European Heart Journal
IS - 21
ER -