Recovery of Left Ventricular Systolic Function and Clinical Outcomes in Young Adults With Myocardial Infarction

Research output: Contribution to journalArticle

Wanda Y. Wu, David W. Biery, Avinainder Singh, Sanjay Divakaran, Adam N. Berman, Gloria Ayuba, Ersilia M. DeFilippis, Khurram Nasir, James L. Januzzi, Marcelo F. Di Carli, Deepak L. Bhatt, Ron Blankstein

Background: Left ventricular ejection fraction (EF) recovery is associated with better long-term outcomes after myocardial infarction (MI). However, the association between long-term outcomes and EF recovery among young MI patients has not been investigated. Objectives: This study sought to evaluate the prevalence of left ventricular systolic dysfunction among patients who experience their first MI at a young age and to compare outcomes between those who recovered their EF versus those who did not. Methods: The YOUNG-MI registry is a retrospective cohort study of patients who experienced an MI at ≤50 years of age. EF at the time of MI and within 180 days post-MI were determined from all available medical records. The primary outcomes were all-cause and cardiovascular mortality. Results: There were 1,724 patients with baseline EF data: 503 (29%) had EF <50%, whereas 1,221 (71%) had a normal baseline EF. Patients with lower EF were more likely to have experienced ST-segment elevation MI, have higher troponin values, and have more severe angiographic coronary artery disease. Among patients with abnormal baseline EF, information on follow-up EF was available for 216, of whom 90 (42%) recovered their EF to ≥50%. Patients who experienced EF recovery had less severe angiographic disease, lower alcohol use, and a lower burden of comorbidities. Over a median follow-up of 11.1 years, EF recovery was associated with an ∼8-fold reduction in all-cause mortality (adjusted hazard ratio: 0.12; p = 0.001) and a ∼10-fold reduction in cardiovascular mortality (adjusted hazard ratio: 0.10; p = 0.025). Conclusions: Nearly one-third of young patients presented with left ventricular dysfunction post-MI. Among them, EF recovery occurred in more than 40% and was independently associated with a substantial decrease in all-cause and cardiovascular mortality.

Original languageEnglish (US)
Pages (from-to)2804-2815
Number of pages12
JournalJournal of the American College of Cardiology
Volume75
Issue number22
DOIs
StatePublished - Jun 9 2020

PMID: 32498808

Altmetrics

Cite this

Standard

Recovery of Left Ventricular Systolic Function and Clinical Outcomes in Young Adults With Myocardial Infarction. / Wu, Wanda Y.; Biery, David W.; Singh, Avinainder; Divakaran, Sanjay; Berman, Adam N.; Ayuba, Gloria; DeFilippis, Ersilia M.; Nasir, Khurram; Januzzi, James L.; Di Carli, Marcelo F.; Bhatt, Deepak L.; Blankstein, Ron.

In: Journal of the American College of Cardiology, Vol. 75, No. 22, 09.06.2020, p. 2804-2815.

Research output: Contribution to journalArticle

Harvard

Wu, WY, Biery, DW, Singh, A, Divakaran, S, Berman, AN, Ayuba, G, DeFilippis, EM, Nasir, K, Januzzi, JL, Di Carli, MF, Bhatt, DL & Blankstein, R 2020, 'Recovery of Left Ventricular Systolic Function and Clinical Outcomes in Young Adults With Myocardial Infarction' Journal of the American College of Cardiology, vol. 75, no. 22, pp. 2804-2815. https://doi.org/10.1016/j.jacc.2020.03.074

APA

Wu, W. Y., Biery, D. W., Singh, A., Divakaran, S., Berman, A. N., Ayuba, G., ... Blankstein, R. (2020). Recovery of Left Ventricular Systolic Function and Clinical Outcomes in Young Adults With Myocardial Infarction. Journal of the American College of Cardiology, 75(22), 2804-2815. https://doi.org/10.1016/j.jacc.2020.03.074

Vancouver

Wu WY, Biery DW, Singh A, Divakaran S, Berman AN, Ayuba G et al. Recovery of Left Ventricular Systolic Function and Clinical Outcomes in Young Adults With Myocardial Infarction. Journal of the American College of Cardiology. 2020 Jun 9;75(22):2804-2815. https://doi.org/10.1016/j.jacc.2020.03.074

Author

Wu, Wanda Y. ; Biery, David W. ; Singh, Avinainder ; Divakaran, Sanjay ; Berman, Adam N. ; Ayuba, Gloria ; DeFilippis, Ersilia M. ; Nasir, Khurram ; Januzzi, James L. ; Di Carli, Marcelo F. ; Bhatt, Deepak L. ; Blankstein, Ron. / Recovery of Left Ventricular Systolic Function and Clinical Outcomes in Young Adults With Myocardial Infarction. In: Journal of the American College of Cardiology. 2020 ; Vol. 75, No. 22. pp. 2804-2815.

BibTeX

@article{c05a770b0c85430bb2abdf711a4c7d5a,
title = "Recovery of Left Ventricular Systolic Function and Clinical Outcomes in Young Adults With Myocardial Infarction",
abstract = "Background: Left ventricular ejection fraction (EF) recovery is associated with better long-term outcomes after myocardial infarction (MI). However, the association between long-term outcomes and EF recovery among young MI patients has not been investigated. Objectives: This study sought to evaluate the prevalence of left ventricular systolic dysfunction among patients who experience their first MI at a young age and to compare outcomes between those who recovered their EF versus those who did not. Methods: The YOUNG-MI registry is a retrospective cohort study of patients who experienced an MI at ≤50 years of age. EF at the time of MI and within 180 days post-MI were determined from all available medical records. The primary outcomes were all-cause and cardiovascular mortality. Results: There were 1,724 patients with baseline EF data: 503 (29{\%}) had EF <50{\%}, whereas 1,221 (71{\%}) had a normal baseline EF. Patients with lower EF were more likely to have experienced ST-segment elevation MI, have higher troponin values, and have more severe angiographic coronary artery disease. Among patients with abnormal baseline EF, information on follow-up EF was available for 216, of whom 90 (42{\%}) recovered their EF to ≥50{\%}. Patients who experienced EF recovery had less severe angiographic disease, lower alcohol use, and a lower burden of comorbidities. Over a median follow-up of 11.1 years, EF recovery was associated with an ∼8-fold reduction in all-cause mortality (adjusted hazard ratio: 0.12; p = 0.001) and a ∼10-fold reduction in cardiovascular mortality (adjusted hazard ratio: 0.10; p = 0.025). Conclusions: Nearly one-third of young patients presented with left ventricular dysfunction post-MI. Among them, EF recovery occurred in more than 40{\%} and was independently associated with a substantial decrease in all-cause and cardiovascular mortality.",
keywords = "ejection fraction, heart failure, myocardial infarction, prevention",
author = "Wu, {Wanda Y.} and Biery, {David W.} and Avinainder Singh and Sanjay Divakaran and Berman, {Adam N.} and Gloria Ayuba and DeFilippis, {Ersilia M.} and Khurram Nasir and Januzzi, {James L.} and {Di Carli}, {Marcelo F.} and Bhatt, {Deepak L.} and Ron Blankstein",
year = "2020",
month = "6",
day = "9",
doi = "10.1016/j.jacc.2020.03.074",
language = "English (US)",
volume = "75",
pages = "2804--2815",
journal = "Journal of the American College of Cardiology.",
issn = "0735-1097",
publisher = "Elsevier",
number = "22",

}

RIS

TY - JOUR

T1 - Recovery of Left Ventricular Systolic Function and Clinical Outcomes in Young Adults With Myocardial Infarction

AU - Wu, Wanda Y.

AU - Biery, David W.

AU - Singh, Avinainder

AU - Divakaran, Sanjay

AU - Berman, Adam N.

AU - Ayuba, Gloria

AU - DeFilippis, Ersilia M.

AU - Nasir, Khurram

AU - Januzzi, James L.

AU - Di Carli, Marcelo F.

AU - Bhatt, Deepak L.

AU - Blankstein, Ron

PY - 2020/6/9

Y1 - 2020/6/9

N2 - Background: Left ventricular ejection fraction (EF) recovery is associated with better long-term outcomes after myocardial infarction (MI). However, the association between long-term outcomes and EF recovery among young MI patients has not been investigated. Objectives: This study sought to evaluate the prevalence of left ventricular systolic dysfunction among patients who experience their first MI at a young age and to compare outcomes between those who recovered their EF versus those who did not. Methods: The YOUNG-MI registry is a retrospective cohort study of patients who experienced an MI at ≤50 years of age. EF at the time of MI and within 180 days post-MI were determined from all available medical records. The primary outcomes were all-cause and cardiovascular mortality. Results: There were 1,724 patients with baseline EF data: 503 (29%) had EF <50%, whereas 1,221 (71%) had a normal baseline EF. Patients with lower EF were more likely to have experienced ST-segment elevation MI, have higher troponin values, and have more severe angiographic coronary artery disease. Among patients with abnormal baseline EF, information on follow-up EF was available for 216, of whom 90 (42%) recovered their EF to ≥50%. Patients who experienced EF recovery had less severe angiographic disease, lower alcohol use, and a lower burden of comorbidities. Over a median follow-up of 11.1 years, EF recovery was associated with an ∼8-fold reduction in all-cause mortality (adjusted hazard ratio: 0.12; p = 0.001) and a ∼10-fold reduction in cardiovascular mortality (adjusted hazard ratio: 0.10; p = 0.025). Conclusions: Nearly one-third of young patients presented with left ventricular dysfunction post-MI. Among them, EF recovery occurred in more than 40% and was independently associated with a substantial decrease in all-cause and cardiovascular mortality.

AB - Background: Left ventricular ejection fraction (EF) recovery is associated with better long-term outcomes after myocardial infarction (MI). However, the association between long-term outcomes and EF recovery among young MI patients has not been investigated. Objectives: This study sought to evaluate the prevalence of left ventricular systolic dysfunction among patients who experience their first MI at a young age and to compare outcomes between those who recovered their EF versus those who did not. Methods: The YOUNG-MI registry is a retrospective cohort study of patients who experienced an MI at ≤50 years of age. EF at the time of MI and within 180 days post-MI were determined from all available medical records. The primary outcomes were all-cause and cardiovascular mortality. Results: There were 1,724 patients with baseline EF data: 503 (29%) had EF <50%, whereas 1,221 (71%) had a normal baseline EF. Patients with lower EF were more likely to have experienced ST-segment elevation MI, have higher troponin values, and have more severe angiographic coronary artery disease. Among patients with abnormal baseline EF, information on follow-up EF was available for 216, of whom 90 (42%) recovered their EF to ≥50%. Patients who experienced EF recovery had less severe angiographic disease, lower alcohol use, and a lower burden of comorbidities. Over a median follow-up of 11.1 years, EF recovery was associated with an ∼8-fold reduction in all-cause mortality (adjusted hazard ratio: 0.12; p = 0.001) and a ∼10-fold reduction in cardiovascular mortality (adjusted hazard ratio: 0.10; p = 0.025). Conclusions: Nearly one-third of young patients presented with left ventricular dysfunction post-MI. Among them, EF recovery occurred in more than 40% and was independently associated with a substantial decrease in all-cause and cardiovascular mortality.

KW - ejection fraction

KW - heart failure

KW - myocardial infarction

KW - prevention

UR - http://www.scopus.com/inward/record.url?scp=85085044215&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85085044215&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2020.03.074

DO - 10.1016/j.jacc.2020.03.074

M3 - Article

VL - 75

SP - 2804

EP - 2815

JO - Journal of the American College of Cardiology.

T2 - Journal of the American College of Cardiology.

JF - Journal of the American College of Cardiology.

SN - 0735-1097

IS - 22

ER -

ID: 63472495