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Can an elderly woman's heart be too strong? Increased mortality with high versus normal ejection fraction after an acute coronary syndrome. The Global Registry of Acute Coronary Events
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Authors
Saab, Fadi A.Steg, Phillippe Gabriel
Avezum, Alvaro
Lopez-Sendon, Jose
Anderson, Frederick A. Jr.
Huang, Wei
Eagle, Kim A.
UMass Chan Affiliations
Center for Outcomes ResearchDocument Type
Journal ArticlePublication Date
2010-11-26Keywords
Acute Coronary SyndromeAge Factors
Aged
Female
Follow-Up Studies
Hospital Mortality
Humans
Prognosis
*Registries
Retrospective Studies
Risk Factors
Severity of Illness Index
Stroke Volume
Survival Rate
Time Factors
Ventricular Function, Left
World Health
Health Services Research
Metadata
Show full item recordAbstract
BACKGROUND: Coronary artery disease is the leading cause of death in women. We sought to validate previous clinical experience in which we have observed that elderly women with a very high left ventricular ejection fraction (LVEF) are at increased risk of death compared with elderly women with acute coronary syndromes with a normal LVEF. METHODS: Data from 5,127 elderly female patients (age >65 years) enrolled in the Global Registry of Acute Coronary Events were collected. Patients were divided into 3 groups based on their LVEF: group I had a low ejection fraction (<55%), group II had a normal ejection fraction (55%-65%), and group III had a high ejection fraction (>65%). chi(2) test and multiple logistic regression analysis were performed. The main outcome measures were death in-hospital and death, stroke, rehospitalization, and myocardial infarction at 6-month follow-up. RESULTS: Hospital mortality was 12% in group I. Patients in group III were more likely to die in-hospital than those in group II (P = .003). Multivariable logistic regression showed that high ejection fraction was an independent predictor of hospital death (odds ratio [OR] 2.5, 95% CI [CI] 1.2-5.2, P = .01), 6-month death (OR 2.0, 95% CI 1.1-3.4, P = .01), and cardiac arrest/ventricular fibrillation (OR 2.5, 95% CI 1.2-5.0, P = .01) compared with the normal ejection fraction group. CONCLUSIONS: Having a very high LVEF (> 65%) is associated with worse survival and higher rates of sudden cardiac death than an LVEF considered to be in the reference range.Source
Am Heart J. 2010 Nov;160(5):849-54. Link to article on publisher's siteDOI
10.1016/j.ahj.2010.07.018Permanent Link to this Item
http://hdl.handle.net/20.500.14038/27191PubMed ID
21095271Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.ahj.2010.07.018