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An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: the VALIANT registry.

Abstract：

AIMS: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. METHODS AND RESULTS: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. CONCLUSIONS: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.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Velazquez EJ,Francis GS,Armstrong PW,Aylward PE,Diaz R,O'Connor CM,White HD,Henis M,Rittenhouse LM,Kilaru R,van Gilst W,Ertl G,Maggioni AP,Spac J,Weaver WD,Rouleau JL,McMurray JJ,Pfeffer MA,Califf RM,VALIANT registr

doi

10.1016/j.ehj.2004.08.006

subject

Has Abstract

pub_date

2004-11-01 00:00:00

pages

1911-9

issue

eissn

0195-668X

issn

1522-9645

pii

S0195-668X(04)00567-6

journal_volume

pub_type

杂志文章,多中心研究

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An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: the VALIANT registry.