Risk Stratification and Survival after Myocardial Infarction

Abstract

We assessed the role of physiologic measurements of heart function in predicting mortality after myocardial infarction. Most of the 866 patients enrolled in our multicenter study underwent 24-hour Holter monitoring and determination of the resting radionuclide ventricular ejection fraction before discharge. Univariate analyses showed a progressive increase in cardiac mortality during one year as the ejection fraction fell below 0.40 and as the number of ventricular ectopic depolarizations exceeded one per hour. Only four risk factors among eight prespecified variables were independent predictors of mortality: an ejection fraction below 0.40, ventricular ectopy of 10 or more depolarizations per hour, advanced New York Heart Association functional class before infarction, and rales heard in the upper two thirds of the lung fields while the patient was in the coronary-care unit. Various combinations of these four factors identified five risk subgroups with two-year mortality rates ranging from 3 per cent (no factors) to 60 per cent (all four factors).

Heart Rate Turbulence Is a Powerful Predictor of Cardiac Death and Ventricular Arrhythmias in Postmyocardial Infarction and Heart Failure Patients

“…[38][39][40][41] Overall, a total of 25 and 20 cohorts of patients were included in the qualitative and quantitative analysis, respectively. Despite they met eligibility criteria, 5 studies 27,28,30,36,37 were not included in the meta-analysis because of heterogeneity in data presentation (raw data were not available nor derivable).…”

Left Ventricular Functional Analysis Using 64-Slice Multidetector Row Computed Tomography: Comparison with Left Ventriculography and Cardiovascular Magnetic Resonance

“…For diagnosis, disease stratification, treatment planning and prognosis of different cardiac diseases, the accurate and reliable assessment of left ventricular (LV) function is important [1,2,3,4]. Various imaging modalities are in use for the determination of regional and global LV function.…”

Implantable Cardioverter‐Defibrillators for Secondary Prevention of Sudden Cardiac Death: A Review

“…Other factors include male sex, increasing age, and black race 11, 12, 13. Among patients with coronary heart disease, left ventricular systolic dysfunction is one of the most significant predictors of overall mortality, in part due to a rate of SCA that increases with decreasing left ventricular ejection fraction (LVEF) 14, 15. Other forms of structural heart disease associated with high SCA risk, including hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, congenital anomalies, sarcoid cardiomyopathy, and left ventricular hypertrophy are rarer, accounting for fewer cases of SCA.…”