Predictors and prognostic impact of left ventricular ejection fraction trajectories in patients with ST-segment elevation myocardial infarction.
Predictors and prognostic impact of left ventricular ejection fraction trajectories in patients with ST-segment elevation myocardial infarction.
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DOI：
10.1007/s40520-022-02087-y
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发表时间：
2022-06
影响因子：
4
通讯作者：
Peng, Wenhui
中科院分区：
文献类型：
--
作者：
Lei, Zhijun;Li, Bingyu;Li, Bo;Peng, Wenhui
ST段抬高型心肌梗死（STEMI）后左室射血分数（LVEF）轨迹的证据很少。我们的目的是确定STEMI后的LVEF轨迹，并探讨其预测因素及其与预后的关系。这是一项针对STEMI患者的回顾性、观察性研究。在基线LVEF <50%的患者中，通过潜在类轨迹模型识别LVEF轨迹。我们使用逻辑回归分析来研究LVEF轨迹的预测因素。采用考克斯比例风险模型评估LVEF轨迹对预后的影响。主要结局为心血管死亡率和心力衰竭（HF）再住院。1179例患者中，572例基线LVEF正常（≥ 50%），607例基线LVEF降低（< 50%）。在基线LVEF降低的患者中确定了两种不同的LVEF轨迹：LVEF恢复组和LVEF持续降低组。基线LVEF升高、肌钙蛋白T峰值降低、非前壁心肌梗死和心率降低均与LVEF恢复独立相关。多变量校正后，与基线LVEF正常的患者相比，LVEF持续降低的患者发生心血管死亡（HR 7.49，95% CI 1.94-28.87，P = 0.003）和HF再住院（HR 3.54，95% CI 1.56-8.06，P = 0.003）的风险增加。另一方面，LVEF恢复的患者无心血管死亡和HF再住院的显著风险。我们的研究表明STEMI后有两种不同的LVEF轨迹，持续降低的LVEF轨迹与不良预后相关。此外，几个基线特征可以预测LVEF恢复。在线版本包含补充材料，可在10.1007/s40520-022-02087-y获得。
There is little evidence on left ventricular ejection fraction (LVEF) trajectories after ST-segment elevation myocardial infarction (STEMI). We aim to identify the LVEF trajectories after STEMI and explore their predictors and association with prognosis. This is a retrospective, observational study of STEMI patients. The LVEF trajectories were identified by the latent class trajectory model in patients with baseline LVEF < 50%. We used logistic regression analysis to investigate the predictors for LVEF trajectories. The Cox proportional hazard model was used to assess the impact of LVEF trajectories on prognosis. The primary outcomes were cardiovascular mortality and heart failure (HF) rehospitalization. 572 of 1179 patients presented with baseline normal LVEF (≥ 50%) and 607 with baseline reduced LVEF (< 50%). Two distinct LVEF trajectories were identified in patients with baseline reduced LVEF: recovered LVEF group and persistently reduced LVEF group. Higher baseline LVEF, lower peak troponin T, non-anterior MI, and lower heart rates were all found to be independently associated with LVEF recovery. After multivariate adjustments, patients with persistently reduced LVEF experienced an increased risk of cardiovascular mortality (HR 7.49, 95% CI 1.94–28.87, P = 0.003) and HF rehospitalization (HR 3.54, 95% CI 1.56–8.06 P = 0.003) compared to patients with baseline normal LVEF. Patients with recovered LVEF, on the other hand, showed no significant risk of cardiovascular mortality and HF rehospitalization. Our study indicated two distinct LVEF trajectories after STEMI and that the persistently reduced LVEF trajectory was related to poor prognosis. In addition, several baseline characteristics can predict LVEF recovery. The online version contains supplementary material available at 10.1007/s40520-022-02087-y.
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影响因子：
2.8
作者：
Parodi, Guido;Memisha, Gentian;Antoniucci, David
通讯作者：
Antoniucci, David
DOI：
10.1016/j.ddmec.2007.12.006
发表时间：
2007-01-01
期刊：
Drug discovery today. Disease mechanisms
影响因子：
--
作者：
French, Brent A;Kramer, Christopher M
通讯作者：
Kramer, Christopher M
影响因子：
4.8
作者：
Chew, Derek S.;Wilton, Stephen B.;Exner, Derek V.
通讯作者：
Exner, Derek V.
影响因子：
39.3
作者：
BOURKE, S;CONROY, RM;ROBINSON, K
通讯作者：
ROBINSON, K
DOI：
10.1016/s0735-1097(03)01057-x
发表时间：
2003-10-15
影响因子：
24
作者：
Lewis, EF;Moye, LA;Pfeffer, MA
通讯作者：
Pfeffer, MA