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Left ventricular ejection fraction to predict early mortality in patients with non-ST-segment elevation acute coronary syndromes.

Abstract：

BACKGROUND:Improvement in risk stratification of patients with non-ST-segment elevation acute coronary syndrome (ACS) is a gateway to a more judicious treatment. This study examines whether the routine determination of left ventricular ejection fraction (EF) adds significant prognostic information to currently recommended stratifiers. METHODS:Several predictors of inhospital mortality were prospectively characterized in a registry study of 1104 consecutive patients, for whom an EF was determined, who were admitted for an ACS. Multiple regression models were constructed using currently recommended clinical, electrocardiographic, and blood marker stratifiers, and values of EF were incorporated into the models. RESULTS:Age, ST-segment shifts, elevation of cardiac markers, and the Thrombolysis in Myocardial Infarction (TIMI) risk score all predicted mortality (P < .0001). Adding EF into the model improved the prediction of mortality (C statistic 0.73 vs 0.67). The odds of death increased by a factor of 1.042 for each 1% decrement in EF. By receiver operating curves, an EF cutoff of 48% provided the best predictive value. Mortality rates were 3.3 times higher within each TIMI risk score stratum in patients with an EF of 48% or lower as compared with those with higher. CONCLUSIONS:The TIMI risk score predicts inhospital mortality in a broad population of patients with ACS. The further consideration of EF adds significant prognostic information.

journal_name

Am Heart J

journal_title

American heart journal

authors

Bosch X,Théroux P

doi

10.1016/j.ahj.2004.09.027

subject

Has Abstract

pub_date

2005-08-01 00:00:00

pages

215-20

issue

2

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(04)00659-3

journal_volume

150

pub_type

杂志文章,多中心研究

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