Left ventricular systolic dysfunction after acute myocardial infarction is associated with a high symptom burden and worse secondary prevention
Bibliographic record
Abstract
Abstract Background LV dysfunction and symptomatic heart failure are common complications after myocardial infarction and the mortality and morbidity burden remain high in this population. Published data are becoming dated, and mainly focus on mortality and hospitalization burden. There is a lack of contemporary data describing patients with post-MI LV dysfunction in terms of symptom burden and secondary prevention measures. Purpose The purpose of this study was to describe patients with different degree of LV dysfunction after MI, their symptom burden, quality of life and adherence to recommended secondary prevention measures in a nationwide patient material. Methods We included 49,564 adults ≥18 years, registered in the SWEDEHEART registry between 2011 and 2018, diagnosed with acute MI, discharged alive and with no previous heart failure. The population was stratified by degree of LV systolic function; EF >50%, EF 40-49%, EF 30-39% and <30%, assessed by echocardiography. Patients were assessed at 6-10 weeks and 10-14 months after MI. Descriptive analyses were used for demographics and characteristics at baseline, first and second follow up. Uni- and multivariable regression analyses was used to examine the associations between LV impairment and symptoms, occupation/working status, readmissions, quality of life (Eq5D), attending cardiac rehabilitation and physical training, smoking status and snuffing. Results Patients with impaired LVEF would more often experience shortness of breath (5.6% vs 32.3% for EF < 30 vs EF >50 at second follow up) (figure). Patients with EF <30% had a lower Eq5D mean at first follow up than patients with normal LVEF (0.77 vs 0.82), but that difference was smaller at second follow-up (0.80 vs 0.83). Subjects with EF <30% did participate in heart rehabilitation to a lesser extent than those with normal EF, both at the first (28.7% vs 37.4%) as well as the second follow up (44.9% vs 55.5%). In multivariate regression analyses (table), a lower EF was associated with shortness of breath (OR = 7.47, 95% CI = 6.24-8.94) and a lower probability of working or studying (OR = 0.25, 95% CI = 0.20 – 0.31) but not with chest pain. A lower EF was also associated with a lower probability of participating in heart school (OR = 0,67, 95% CI = 0.58-0.68) and physical training (OR = 0.54, 95% CI = 0.46-0.63). Conclusion Left ventricular systolic dysfunction after acute myocardial infarction is associated with a high symptom burden and worse secondary prevention. This may indicate heart rehabilitation programs should be better adapted to this large population with great needs.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".