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Predicting Persistent Left Ventricular Dysfunction Following Myocardial Infarction: The PREDICTS Study.

Abstract：

BACKGROUND:Persistent severe left ventricular (LV) systolic dysfunction after myocardial infarction (MI) is associated with increased mortality and is a class I indication for implantation of a cardioverter-defibrillator. OBJECTIVES:This study developed models and assessed independent predictors of LV recovery to >35% and ≥50% after 90-day follow-up in patients presenting with acute MI and severe LV dysfunction. METHODS:Our multicenter prospective observational study enrolled participants with ejection fraction (EF) of ≤35% at the time of MI (n = 231). Predictors for EF recovery to >35% and ≥50% were identified after multivariate modeling and validated in a separate cohort (n = 236). RESULTS:In the PREDICTS (PREDiction of ICd Treatment Study) study, 43% of patients had persistent EF ≤35%, 31% had an EF of 36% to 49%, and 26% had an EF ≥50%. The model that best predicted recovery of EF to >35% included EF at presentation, length of stay, prior MI, lateral wall motion abnormality at presentation, and peak troponin. The model that best predicted recovery of EF to ≥50% included EF at presentation, peak troponin, prior MI, and presentation with ventricular fibrillation or cardiac arrest. After predictors were transformed into point scores, the lowest point scores predicted a 9% and 4% probability of EF recovery to >35% and ≥50%, respectively, whereas profiles with the highest point scores predicted an 87% and 49% probability of EF recovery to >35% and ≥50%, respectively. CONCLUSIONS:In patients with severe systolic dysfunction following acute MI with an EF ≤35%, 57% had EF recovery to >35%. A model using clinical variables present at the time of MI can help predict EF recovery.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Brooks GC,Lee BK,Rao R,Lin F,Morin DP,Zweibel SL,Buxton AE,Pletcher MJ,Vittinghoff E,Olgin JE,PREDICTS Investigators.

doi

10.1016/j.jacc.2015.12.042

subject

Has Abstract

pub_date

2016-03-15 00:00:00

pages

1186-1196

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(16)00114-5

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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Predicting Persistent Left Ventricular Dysfunction Following Myocardial Infarction: The PREDICTS Study.