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An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: the VALIANT registry

Velazquez, E. J. et al.

European heart journal. VOL 25; NUMBER 21, ; 2004, 1911-1919 -- Elsevier Science B.V., Amsterdam (pages 1911-1919) -- 2004

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  • Title:
    An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: the VALIANT registry
  • Author: Velazquez, E. J.;
    Francis, G. S.;
    Armstrong, P. W.;
    Aylward, P. E.;
    Diaz, R.;
    O’Connor, C. M.;
    White, H. D.;
    Henis, M.;
    Rittenhouse, L. M.;
    Kilaru, R.
  • Found In: European heart journal. VOL 25; NUMBER 21, ; 2004, 1911-1919
  • Journal Title: European heart journal.
  • Subjects: Medicine; Biotechnology; Pharmaceutical Chemistry; LCC: RC; Dewey: 616.12
  • Publication Details: Elsevier Science B.V., Amsterdam
  • Language: English
  • Abstract: AimsWe analysed the contemporary incidence, outcomes, and predictors of heart failure (HF) and/or left ventricular systolic dysfunction (LVSD) before discharge in patients with acute myocardial infarction (MI).The baseline presence of HF or LVSD, or its development during hospitalisation, increases short- and long-term risk after MI, yet its incidence, predictors, and outcomes have not been well described in a large, international, general MI population.Methods and resultsThe VALIANT registry included 5573 consecutive MI patients at 84 hospitals in nine countries from 1999 to 2001. A multivariable logistic survival model was constructed using baseline variables to determine the adjusted mortality risk for those with in-hospital HF and/or LVSD. Baseline variables were also tested for associations with in-hospital HF and/or LVSD.Of the 5566 patients analysed, 42% had HF and/or LVSD during hospitalisation. Their in-hospital mortality rate was 13.0% compared with 2.3% for those without HF and/or without LVSD. After adjustment for other baseline risk factors, in-hospital HF and/or LVSD carried a hazard ratio for in-hospital mortality of 4.12 (95% confidence interval: 3.08–5.56). Patients with HF and/or LVSD also had disproportionately higher rates of other cardiovascular events.ConclusionsHF and/or LVSD is common in the general contemporary MI population and precedes 80.3% of all in-hospital deaths after MI. Survivors of early MI-associated HF and/or LVSD have more complications, longer hospitalisations, and are more likely to die during hospitalisation. Although baseline variables can identify MI patients at highest risk for HF and/or LVSD, such patients are less likely to receive indicated procedures and medical therapies.
  • Identifier: Journal ISSN: 0195-668X
  • Publication Date: 2004
  • Physical Description: Electronic
  • Shelfmark(s): 3829.717500
  • UIN: ETOCRN157802937

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