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


ABSTRACT: 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.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.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).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.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.

SUBMITTER: Brooks GC 

PROVIDER: S-EPMC4854198 | biostudies-literature | 2016 Mar

REPOSITORIES: biostudies-literature

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

Brooks Gabriel C GC   Lee Byron K BK   Rao Rajni R   Lin Feng F   Morin Daniel P DP   Zweibel Steven L SL   Buxton Alfred E AE   Pletcher Mark J MJ   Vittinghoff Eric E   Olgin Jeffrey E JE  

Journal of the American College of Cardiology 20160301 10


<h4>Background</h4>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.<h4>Objectives</h4>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.<h4>Methods</h4>Our multicenter prospective observational study enroll  ...[more]

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