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
dc.contributor.author | Saab, Fadi A. | |
dc.contributor.author | Steg, Phillippe Gabriel | |
dc.contributor.author | Avezum, Alvaro | |
dc.contributor.author | Lopez-Sendon, Jose | |
dc.contributor.author | Anderson, Frederick A. Jr. | |
dc.contributor.author | Huang, Wei | |
dc.contributor.author | Eagle, Kim A. | |
dc.date | 2022-08-11T08:08:08.000 | |
dc.date.accessioned | 2022-08-23T15:43:52Z | |
dc.date.available | 2022-08-23T15:43:52Z | |
dc.date.issued | 2010-11-26 | |
dc.date.submitted | 2011-09-23 | |
dc.identifier.citation | Am Heart J. 2010 Nov;160(5):849-54. <a href="http://dx.doi.org/10.1016/j.ahj.2010.07.018">Link to article on publisher's site</a> | |
dc.identifier.issn | 0002-8703 (Linking) | |
dc.identifier.doi | 10.1016/j.ahj.2010.07.018 | |
dc.identifier.pmid | 21095271 | |
dc.identifier.uri | http://hdl.handle.net/20.500.14038/27191 | |
dc.description.abstract | 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. | |
dc.language.iso | en_US | |
dc.relation | <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=21095271&dopt=Abstract">Link to Article in PubMed</a> | |
dc.relation.url | http://dx.doi.org/10.1016/j.ahj.2010.07.018 | |
dc.subject | Acute Coronary Syndrome | |
dc.subject | Age Factors | |
dc.subject | Aged | |
dc.subject | Female | |
dc.subject | Follow-Up Studies | |
dc.subject | Hospital Mortality | |
dc.subject | Humans | |
dc.subject | Prognosis | |
dc.subject | *Registries | |
dc.subject | Retrospective Studies | |
dc.subject | Risk Factors | |
dc.subject | Severity of Illness Index | |
dc.subject | Stroke Volume | |
dc.subject | Survival Rate | |
dc.subject | Time Factors | |
dc.subject | Ventricular Function, Left | |
dc.subject | World Health | |
dc.subject | Health Services Research | |
dc.title | 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 | |
dc.type | Journal Article | |
dc.source.journaltitle | American heart journal | |
dc.source.volume | 160 | |
dc.source.issue | 5 | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/cor_grace/12 | |
dc.identifier.contextkey | 2254931 | |
html.description.abstract | <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> | |
dc.identifier.submissionpath | cor_grace/12 | |
dc.contributor.department | Center for Outcomes Research | |
dc.source.pages | 849-54 |
Files in this item
This item appears in the following Collection(s)
-
GRACE Publications [114]