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Impaired Diastolic Recovery after Acute Myocardial Infarction as a Predictor of Adverse Events.

Yoon HJ, Kim KH, Kim JY, Cho JY, Yoon NS, Park HW, Hong YJ, Kim JH, Ahn Y, Jeong MH, Cho JG, Park JC - J Cardiovasc Ultrasound (2015)

Bottom Line: MACE included death, recurrent myocardial infarction, and rehospitalization due to heart failure, and these events were compared with the patients' characteristics at baseline.MACE were significantly more frequent in group II than in group I.Age, elevated NT-proBNP, and impaired diastolic recovery were significant independent predictors of MACE.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea.

ABSTRACT

Background: To investigate the impact of left ventricular (LV) diastolic functional recovery on major adverse cardiac events (MACE) 6 months after acute myocardial infarction (AMI) in patients with preserved LV systolic function.

Methods: A total 463 patients with preserved LV systolic function at 6 months after an AMI were divided into two groups based on the extent of diastolic recovery assessed by echocardiography: group I (n = 241) showed improving diastolic function and group II (n = 222) did not. MACE included death, recurrent myocardial infarction, and rehospitalization due to heart failure, and these events were compared with the patients' characteristics at baseline.

Results: Compared with group I, the patients in group II were older and had a higher prevalence of hypertension and diabetes. Blood levels of hemoglobin and triglyceride were lower in group II, whereas the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and of high-sensitivity C-reactive protein were higher in this group than in group I. MACE were significantly more frequent in group II than in group I. Age, elevated NT-proBNP, and impaired diastolic recovery were significant independent predictors of MACE.

Conclusion: Despite improvement in LV systolic function, LV diastolic function had not improved in 222 patients (47.9%) by the 6-month follow-up after the index AMI, and impaired diastolic functional recovery was found to be an independent predictor of MACE. Evaluation of diastolic function would be a useful way to stratify risk in patients discharged after an index AMI.

No MeSH data available.


Related in: MedlinePlus

Comparison of deaths and major adverse cardiac events (MACE) between group I (improving) and group II (non-improving).
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Figure 1: Comparison of deaths and major adverse cardiac events (MACE) between group I (improving) and group II (non-improving).

Mentions: During the follow-up period (mean 910 ± 750 days), MACE occurred in 124 patients (31 deaths, 12 recurrent MIs, and 81 rehospitalizations due to heart failure) and were significantly more frequent in group II than in group I (76 vs. 48, respectively) (p = 0.001) (Fig. 1). Significantly more deaths occurred in group II than in group I (24 vs. 7, respectively) (p = 0.001), but the number of patients with recurrent MI (4 in group I vs. 8 in group II) as well as the number requiring rehospitalization (38 in group I vs. 43 in group II) did not differ significantly between groups I and IIII, 38. Cumulative survival and MACE-free survival rates were significantly lower in group II than in group I on Kaplan-Meier analysis (Fig. 2).


Impaired Diastolic Recovery after Acute Myocardial Infarction as a Predictor of Adverse Events.

Yoon HJ, Kim KH, Kim JY, Cho JY, Yoon NS, Park HW, Hong YJ, Kim JH, Ahn Y, Jeong MH, Cho JG, Park JC - J Cardiovasc Ultrasound (2015)

Comparison of deaths and major adverse cardiac events (MACE) between group I (improving) and group II (non-improving).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4595702&req=5

Figure 1: Comparison of deaths and major adverse cardiac events (MACE) between group I (improving) and group II (non-improving).
Mentions: During the follow-up period (mean 910 ± 750 days), MACE occurred in 124 patients (31 deaths, 12 recurrent MIs, and 81 rehospitalizations due to heart failure) and were significantly more frequent in group II than in group I (76 vs. 48, respectively) (p = 0.001) (Fig. 1). Significantly more deaths occurred in group II than in group I (24 vs. 7, respectively) (p = 0.001), but the number of patients with recurrent MI (4 in group I vs. 8 in group II) as well as the number requiring rehospitalization (38 in group I vs. 43 in group II) did not differ significantly between groups I and IIII, 38. Cumulative survival and MACE-free survival rates were significantly lower in group II than in group I on Kaplan-Meier analysis (Fig. 2).

Bottom Line: MACE included death, recurrent myocardial infarction, and rehospitalization due to heart failure, and these events were compared with the patients' characteristics at baseline.MACE were significantly more frequent in group II than in group I.Age, elevated NT-proBNP, and impaired diastolic recovery were significant independent predictors of MACE.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea.

ABSTRACT

Background: To investigate the impact of left ventricular (LV) diastolic functional recovery on major adverse cardiac events (MACE) 6 months after acute myocardial infarction (AMI) in patients with preserved LV systolic function.

Methods: A total 463 patients with preserved LV systolic function at 6 months after an AMI were divided into two groups based on the extent of diastolic recovery assessed by echocardiography: group I (n = 241) showed improving diastolic function and group II (n = 222) did not. MACE included death, recurrent myocardial infarction, and rehospitalization due to heart failure, and these events were compared with the patients' characteristics at baseline.

Results: Compared with group I, the patients in group II were older and had a higher prevalence of hypertension and diabetes. Blood levels of hemoglobin and triglyceride were lower in group II, whereas the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and of high-sensitivity C-reactive protein were higher in this group than in group I. MACE were significantly more frequent in group II than in group I. Age, elevated NT-proBNP, and impaired diastolic recovery were significant independent predictors of MACE.

Conclusion: Despite improvement in LV systolic function, LV diastolic function had not improved in 222 patients (47.9%) by the 6-month follow-up after the index AMI, and impaired diastolic functional recovery was found to be an independent predictor of MACE. Evaluation of diastolic function would be a useful way to stratify risk in patients discharged after an index AMI.

No MeSH data available.


Related in: MedlinePlus