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dc.contributor.authorSaab, Fadi A.
dc.contributor.authorSteg, Phillippe Gabriel
dc.contributor.authorAvezum, Alvaro
dc.contributor.authorLopez-Sendon, Jose
dc.contributor.authorAnderson, Frederick A. Jr.
dc.contributor.authorHuang, Wei
dc.contributor.authorEagle, Kim A.
dc.date2022-08-11T08:08:08.000
dc.date.accessioned2022-08-23T15:43:52Z
dc.date.available2022-08-23T15:43:52Z
dc.date.issued2010-11-26
dc.date.submitted2011-09-23
dc.identifier.citationAm 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.issn0002-8703 (Linking)
dc.identifier.doi10.1016/j.ahj.2010.07.018
dc.identifier.pmid21095271
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27191
dc.description.abstractBACKGROUND: 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.isoen_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.urlhttp://dx.doi.org/10.1016/j.ahj.2010.07.018
dc.subjectAcute Coronary Syndrome
dc.subjectAge Factors
dc.subjectAged
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectHospital Mortality
dc.subjectHumans
dc.subjectPrognosis
dc.subject*Registries
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectSeverity of Illness Index
dc.subjectStroke Volume
dc.subjectSurvival Rate
dc.subjectTime Factors
dc.subjectVentricular Function, Left
dc.subjectWorld Health
dc.subjectHealth Services Research
dc.titleCan 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.typeJournal Article
dc.source.journaltitleAmerican heart journal
dc.source.volume160
dc.source.issue5
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/cor_grace/12
dc.identifier.contextkey2254931
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.submissionpathcor_grace/12
dc.contributor.departmentCenter for Outcomes Research
dc.source.pages849-54


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