Copyright © 2004 by the European Society of Cardiology.
Clinical research
An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: the VALIANT registry
a Division of Cardiology, Department of Medicine, Duke University Medical Center and Duke Clinical Research Institute, P.O. Box 17969, Durham, NC 27715, USA
b The Cleveland Clinic Foundation, Cleveland, OH, USA
c University of Alberta, Edmonton, Alberta, Canada
d Flinders Medical Centre, Bedford Park, South Australia
e Estudios Cardiologicos, Latinoamerica, Santa Fe, Argentina
f Green Lane Hospital, Auckland, New Zealand
g Medical Pharmaceutical Consultants, Randolph, NJ, USA
h Rijksuniversiteit Groningen, Groningen, The Netherlands
i Medizinische Universitätsklinik, Würzburg, Germany
j ANMCO Research Center, Florence, Italy
k Faculty Hospital of St. Anna, Brno, Czech Republic
l Henry Ford Hospital, Detroit, MI, USA
m University of Toronto, Ont., Canada
n University of Glasgow, Glasgow, UK
o Brigham and Women's Hospital, Boston, MA, USA
Received October 2, 2003; revised July 20, 2004; accepted August 5, 2004 * Corresponding author. Tel.: +1 919 668 8041; fax: +1 919 668 7169 (E-mail: velaz002{at}dcri.duke.edu).
AIMS: We 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 RESULTS: The 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.
CONCLUSIONS: HF 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.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  C. Adamopoulos, A. Ahmed, R. Fay, M. Angioi, G. Filippatos, J. Vincent, B. Pitt, F. Zannad, and the EPHESUS Investigators Timing of eplerenone initiation and outcomes in patients with heart failure after acute myocardial infarction complicated by left ventricular systolic dysfunction: insights from the EPHESUS trial Eur J Heart Fail, November 1, 2009; 11(11): 1099 - 1105. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Krum, S. P. Curtis, A. Kaur, H. Wang, S. S. Smugar, M. R. Weir, L. Laine, D. C. Brater, and C. P. Cannon Baseline factors associated with congestive heart failure in patients receiving etoricoxib or diclofenac: multivariate analysis of the MEDAL program Eur J Heart Fail, June 1, 2009; 11(6): 542 - 550. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. S. Jhund and J. J.V. McMurray Heart Failure After Acute Myocardial Infarction: A Lost Battle in the War on Heart Failure? Circulation, November 11, 2008; 118(20): 2019 - 2021. [Full Text] [PDF]
|
|
|
|
 |
|
 N. M. Albert Improving Medication Adherence in Chronic Cardiovascular Disease Crit. Care Nurse, October 1, 2008; 28(5): 54 - 64. [Full Text] [PDF]
|
|
|
|
 |
|
 J. C. Huffman, F. A. Smith, M. A. Blais, A. M. Taylor, J. L. Januzzi, and G. L. Fricchione Pre-Existing Major Depression Predicts In-Hospital Cardiac Complications After Acute Myocardial Infarction Psychosomatics, July 1, 2008; 49(4): 309 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. F. Lewis, E. J. Velazquez, S. D. Solomon, A. S. Hellkamp, J. J.V. McMurray, J. Mathias, J.-L. Rouleau, A. P. Maggioni, K. Swedberg, L. Kober, et al. Predictors of the first heart failure hospitalization in patients who are stable survivors of myocardial infarction complicated by pulmonary congestion and/or left ventricular dysfunction: a VALIANT study Eur. Heart J., March 2, 2008; 29(6): 748 - 756. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. G. Steg Overview of large morbidity/mortality trials with ivabradine: focus on the BEAUTIfUL study Eur. Heart J. Suppl., September 1, 2007; 9(suppl_F): F15 - F19. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Dart, J. E. Otterstad, B.-A. Kirwan, J. D. Parker, S. de Brouwer, P. A. Poole-Wilson, and J. Lubsen Predictive value of local and core laboratory echocardiographic assessment of cardiac function in patients with chronic stable angina: The ACTION study Eur J Echocardiogr, August 1, 2007; 8(4): 275 - 283. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. P Liu, A. Maggioni, and E. J Velazquez Use of Valsartan in Post-Myocardial Infarction and Heart Failure Patients Journal of Renin-Angiotensin-Aldosterone System, March 1, 2006; 7(1_suppl): S19 - S22. [Abstract] [PDF]
|
|
|
|
 |
|
 A. F. Hernandez, E. J. Velazquez, S. D. Solomon, R. Kilaru, R. Diaz, C. M. O'Connor, G. Ertl, A. P. Maggioni, J.-L. Rouleau, W. van Gilst, et al. Left Ventricular Assessment in Myocardial Infarction: The VALIANT Registry Arch Intern Med, October 10, 2005; 165(18): 2162 - 2169. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Pitt, H. White, J. Nicolau, F. Martinez, M. Gheorghiade, M. Aschermann, D. J. van Veldhuisen, F. Zannad, H. Krum, R. Mukherjee, et al. Eplerenone Reduces Mortality 30 Days After Randomization Following Acute Myocardial Infarction in Patients With Left Ventricular Systolic Dysfunction and Heart Failure J. Am. Coll. Cardiol., August 2, 2005; 46(3): 425 - 431. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R Weir and J J V McMurray Treatments that improve outcome in the patient with heart failure, left ventricular systolic dysfunction, or both after acute myocardial infarction Heart, May 1, 2005; 91(suppl_2): ii17 - ii20. [Abstract] [Full Text] [PDF]
|
|