TY - JOUR
T1 - The relationships of left ventricular ejection fraction, end-systolic volume index and infarct size to six-month mortality after hospital discharge following myocardial infarction treated by thrombolysis
AU - Burns, Robert J.
AU - Gibbons, Raymond J.
AU - Yi, Qilong
AU - Roberts, Robin S.
AU - Miller, Todd D.
AU - Schaer, Gary L.
AU - Anderson, Jeffrey L.
AU - Yusuf, Salim
N1 - Funding Information:
The Collaborative Organization for RheothRx Evaluation (CORE) trial was supported by a grant from Burroughs Wellcome.
PY - 2002/1/2
Y1 - 2002/1/2
N2 - OBJECTIVES: We sought to relate left ventricular ejection fraction (EF), end-systolic volume index (ESVI) and infarct size (IS), as measured in a single randomized trial, to six-month mortality after myocardial infarction (MI) treated with thrombolysis. BACKGROUND: These three prognostic indicators have never been compared in the same study group. METHODS: Radionuclide angiographic and single-photon emission computed tomographic sestamibi measurements of IS were performed in 1,194 and 1,181 patients, respectively, of the 2,948 patients enrolled in the Collaborative Organization for RheothRx Evaluation (CORE) trial. Ejection fraction, ESVI and IS, as measured by central laboratories in these radionuclide substudies, were tested for their association with six-month mortality. RESULTS: Ejection fraction (n = 1,137; p < 0.0001), ESVI (n = 945; p = 0.055) and IS (n = 1,164; p = 0.03) were all associated with six-month mortality. Each of these measurements was significantly correlated with the other two, regardless of MI location. In an "overlap" group of 753 patients (25.5% of the population; 13 deaths) in whom all three measurements were available, EF (p = 0.001) was a stronger predictor than ESVI (p = 0.005) or IS (p = 0.01). Neither of the other two measurements added independent prognostic information. The highest risk subgroup (EF < 30%) had an 11% six-month mortality, but comprised only 95 patients (8.3%). CONCLUSIONS: Ejection fraction, ESVI and IS measurements performed one to two weeks after MI can each predict six-month mortality. Ejection fraction was superior to the other two measurements. However, this study had limited power to detect independent significance of ESVI or IS.
AB - OBJECTIVES: We sought to relate left ventricular ejection fraction (EF), end-systolic volume index (ESVI) and infarct size (IS), as measured in a single randomized trial, to six-month mortality after myocardial infarction (MI) treated with thrombolysis. BACKGROUND: These three prognostic indicators have never been compared in the same study group. METHODS: Radionuclide angiographic and single-photon emission computed tomographic sestamibi measurements of IS were performed in 1,194 and 1,181 patients, respectively, of the 2,948 patients enrolled in the Collaborative Organization for RheothRx Evaluation (CORE) trial. Ejection fraction, ESVI and IS, as measured by central laboratories in these radionuclide substudies, were tested for their association with six-month mortality. RESULTS: Ejection fraction (n = 1,137; p < 0.0001), ESVI (n = 945; p = 0.055) and IS (n = 1,164; p = 0.03) were all associated with six-month mortality. Each of these measurements was significantly correlated with the other two, regardless of MI location. In an "overlap" group of 753 patients (25.5% of the population; 13 deaths) in whom all three measurements were available, EF (p = 0.001) was a stronger predictor than ESVI (p = 0.005) or IS (p = 0.01). Neither of the other two measurements added independent prognostic information. The highest risk subgroup (EF < 30%) had an 11% six-month mortality, but comprised only 95 patients (8.3%). CONCLUSIONS: Ejection fraction, ESVI and IS measurements performed one to two weeks after MI can each predict six-month mortality. Ejection fraction was superior to the other two measurements. However, this study had limited power to detect independent significance of ESVI or IS.
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U2 - 10.1016/S0735-1097(01)01711-9
DO - 10.1016/S0735-1097(01)01711-9
M3 - Article
C2 - 11755283
AN - SCOPUS:0037005820
SN - 0735-1097
VL - 39
SP - 30
EP - 36
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 1
ER -