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Prevalence and prognostic impact of left ventricular systolic dysfunction or pulmonary congestion after acute myocardial infarction

AIMS: The aim was to describe the prevalence, characteristics, and outcome of patients with acute myocardial infarction (MI) developing left ventricular (LV) systolic dysfunction or pulmonary congestion by applying different criteria to define the population. METHODS AND RESULTS: In patients with MI...

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Autores principales: Hamilton, Eleonora, Desta, Liyew, Lundberg, Anna, Alfredsson, Joakim, Christersson, Christina, Erlinge, David, Kellerth, Thomas, Lindmark, Krister, Omerovic, Elmir, Reitan, Christian, Jernberg, Tomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10053177/
https://www.ncbi.nlm.nih.gov/pubmed/36732932
http://dx.doi.org/10.1002/ehf2.14301
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author Hamilton, Eleonora
Desta, Liyew
Lundberg, Anna
Alfredsson, Joakim
Christersson, Christina
Erlinge, David
Kellerth, Thomas
Lindmark, Krister
Omerovic, Elmir
Reitan, Christian
Jernberg, Tomas
author_facet Hamilton, Eleonora
Desta, Liyew
Lundberg, Anna
Alfredsson, Joakim
Christersson, Christina
Erlinge, David
Kellerth, Thomas
Lindmark, Krister
Omerovic, Elmir
Reitan, Christian
Jernberg, Tomas
author_sort Hamilton, Eleonora
collection PubMed
description AIMS: The aim was to describe the prevalence, characteristics, and outcome of patients with acute myocardial infarction (MI) developing left ventricular (LV) systolic dysfunction or pulmonary congestion by applying different criteria to define the population. METHODS AND RESULTS: In patients with MI included in the Swedish web‐system for enhancement and development of evidence‐based care in heart disease (SWEDEHEART) registry, four different sets of criteria were applied, creating four not mutually exclusive subsets of patients: patients with MI and ejection fraction (EF) < 50% and/or pulmonary congestion (subset 1); EF < 40% and/or pulmonary congestion (subset 2); EF < 40% and/or pulmonary congestion and at least one high‐risk feature (subset 3, PARADISE‐MI like); and EF < 50% and no diabetes mellitus (subset 4, DAPA‐MI like). Subsets 1, 2, 3, and 4 constituted 31.6%, 15.0%, 12.8%, and 22.8% of all patients with MI (n = 87 177), respectively. The age and prevalence of different co‐morbidities varied between subsets. For median age, 70 to 77, for diabetes mellitus, 22 to 33%; for chronic kidney disease, 22 to 38%, for prior MI, 17 to 21%, for atrial fibrillation, 7 to 14%, and for ST‐elevations, 38 to 50%. The cumulative incidence of death or heart failure hospitalization at 3 years was 17.4% (95% CI: 17.1–17.7%) in all MIs; 26.9% (26.3–27.4%) in subset 1; 37.6% (36.7–38.5%) in subset 2; 41.8% (40.7–42.8%) in subset 3; and 22.6% (22.0–23.2%) in subset 4. CONCLUSIONS: Depending on the definition, LV systolic dysfunction or pulmonary congestion is present in 13–32% of all patients with MI and is associated with a two to three times higher risk of subsequent death or HF admission. There is a need to optimize management and improve outcomes for this high‐risk population.
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spelling pubmed-100531772023-03-30 Prevalence and prognostic impact of left ventricular systolic dysfunction or pulmonary congestion after acute myocardial infarction Hamilton, Eleonora Desta, Liyew Lundberg, Anna Alfredsson, Joakim Christersson, Christina Erlinge, David Kellerth, Thomas Lindmark, Krister Omerovic, Elmir Reitan, Christian Jernberg, Tomas ESC Heart Fail Original Articles AIMS: The aim was to describe the prevalence, characteristics, and outcome of patients with acute myocardial infarction (MI) developing left ventricular (LV) systolic dysfunction or pulmonary congestion by applying different criteria to define the population. METHODS AND RESULTS: In patients with MI included in the Swedish web‐system for enhancement and development of evidence‐based care in heart disease (SWEDEHEART) registry, four different sets of criteria were applied, creating four not mutually exclusive subsets of patients: patients with MI and ejection fraction (EF) < 50% and/or pulmonary congestion (subset 1); EF < 40% and/or pulmonary congestion (subset 2); EF < 40% and/or pulmonary congestion and at least one high‐risk feature (subset 3, PARADISE‐MI like); and EF < 50% and no diabetes mellitus (subset 4, DAPA‐MI like). Subsets 1, 2, 3, and 4 constituted 31.6%, 15.0%, 12.8%, and 22.8% of all patients with MI (n = 87 177), respectively. The age and prevalence of different co‐morbidities varied between subsets. For median age, 70 to 77, for diabetes mellitus, 22 to 33%; for chronic kidney disease, 22 to 38%, for prior MI, 17 to 21%, for atrial fibrillation, 7 to 14%, and for ST‐elevations, 38 to 50%. The cumulative incidence of death or heart failure hospitalization at 3 years was 17.4% (95% CI: 17.1–17.7%) in all MIs; 26.9% (26.3–27.4%) in subset 1; 37.6% (36.7–38.5%) in subset 2; 41.8% (40.7–42.8%) in subset 3; and 22.6% (22.0–23.2%) in subset 4. CONCLUSIONS: Depending on the definition, LV systolic dysfunction or pulmonary congestion is present in 13–32% of all patients with MI and is associated with a two to three times higher risk of subsequent death or HF admission. There is a need to optimize management and improve outcomes for this high‐risk population. John Wiley and Sons Inc. 2023-02-02 /pmc/articles/PMC10053177/ /pubmed/36732932 http://dx.doi.org/10.1002/ehf2.14301 Text en © 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Hamilton, Eleonora
Desta, Liyew
Lundberg, Anna
Alfredsson, Joakim
Christersson, Christina
Erlinge, David
Kellerth, Thomas
Lindmark, Krister
Omerovic, Elmir
Reitan, Christian
Jernberg, Tomas
Prevalence and prognostic impact of left ventricular systolic dysfunction or pulmonary congestion after acute myocardial infarction
title Prevalence and prognostic impact of left ventricular systolic dysfunction or pulmonary congestion after acute myocardial infarction
title_full Prevalence and prognostic impact of left ventricular systolic dysfunction or pulmonary congestion after acute myocardial infarction
title_fullStr Prevalence and prognostic impact of left ventricular systolic dysfunction or pulmonary congestion after acute myocardial infarction
title_full_unstemmed Prevalence and prognostic impact of left ventricular systolic dysfunction or pulmonary congestion after acute myocardial infarction
title_short Prevalence and prognostic impact of left ventricular systolic dysfunction or pulmonary congestion after acute myocardial infarction
title_sort prevalence and prognostic impact of left ventricular systolic dysfunction or pulmonary congestion after acute myocardial infarction
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10053177/
https://www.ncbi.nlm.nih.gov/pubmed/36732932
http://dx.doi.org/10.1002/ehf2.14301
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