Improvement of left ventricular ejection fraction in revascularized postmyocardial patients: indication for statistical fallacy
Abstract Background Reduced left ventricular ejection fraction (LVEF) ≤30% is the most powerful prognostic indicator for sudden cardiac death (SCD) in patients after myocardial infarction (MI), but there are little data about long-term changes of LVEF after revascularization and the following implan...
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BMC
2017-07-01
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Series: | BMC Research Notes |
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Online Access: | http://link.springer.com/article/10.1186/s13104-017-2562-4 |
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author | Rona Reibis Annett Salzwedel Klaus Bonaventura Heinz Völler Karl Wegscheider |
author_facet | Rona Reibis Annett Salzwedel Klaus Bonaventura Heinz Völler Karl Wegscheider |
author_sort | Rona Reibis |
collection | DOAJ |
description | Abstract Background Reduced left ventricular ejection fraction (LVEF) ≤30% is the most powerful prognostic indicator for sudden cardiac death (SCD) in patients after myocardial infarction (MI), but there are little data about long-term changes of LVEF after revascularization and the following implantation of a cardioverter defibrillator (ICD). Methods We performed a retrospective analysis of 277 patients with reduced LVEF at least 1 month after MI and complete revascularization. Patients (median time post-MI 23.4 months; 74.3% after PCI, 25.7% after CABG were assigned either to group 1 (LVEF <30%) or group 2 (LVEF 30–40%). Biplane echocardiography was redone after a mean follow-up of 441 ± 220 days. Results LVEF increased significantly in both two groups (group 1: 26.2 ± 4.8% to 32.4 ± 8.5%; p < 0.001; group 2: 38.2 ± 2.5% to 44.4 ± 9.6%; p < 0.001). However, statistical analysis of first and second LVEF measurement by means of a LOWESS regression and with an appropriate correction of the regression towards the mean effect revealed only a moderate increase of the mean LVEF from 35 to 37% (p < 0.001) with a large interindividual variation. Conclusions The impact of early revascularization on LVEF appears to be low in the majority of post-MI heart failure patients. Owing to the high variability, a single measurement may not be reliable enough to justify a decision on ICD indication. |
first_indexed | 2024-12-11T01:49:51Z |
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id | doaj.art-ce8b2de890eb4359a11b1d4ba0877a29 |
institution | Directory Open Access Journal |
issn | 1756-0500 |
language | English |
last_indexed | 2024-12-11T01:49:51Z |
publishDate | 2017-07-01 |
publisher | BMC |
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series | BMC Research Notes |
spelling | doaj.art-ce8b2de890eb4359a11b1d4ba0877a292022-12-22T01:24:47ZengBMCBMC Research Notes1756-05002017-07-011011810.1186/s13104-017-2562-4Improvement of left ventricular ejection fraction in revascularized postmyocardial patients: indication for statistical fallacyRona Reibis0Annett Salzwedel1Klaus Bonaventura2Heinz Völler3Karl Wegscheider4Cardiological Outpatient Clinic Am Park SanssouciCenter of Rehabilitation Research, University of PotsdamDepartment of Cardiology and Angiology, Ernst von Bergmann HospitalCenter of Rehabilitation Research, University of PotsdamDepartment of Medical Biometry and Epidemiology, University Medical Center Hamburg-EppendorfAbstract Background Reduced left ventricular ejection fraction (LVEF) ≤30% is the most powerful prognostic indicator for sudden cardiac death (SCD) in patients after myocardial infarction (MI), but there are little data about long-term changes of LVEF after revascularization and the following implantation of a cardioverter defibrillator (ICD). Methods We performed a retrospective analysis of 277 patients with reduced LVEF at least 1 month after MI and complete revascularization. Patients (median time post-MI 23.4 months; 74.3% after PCI, 25.7% after CABG were assigned either to group 1 (LVEF <30%) or group 2 (LVEF 30–40%). Biplane echocardiography was redone after a mean follow-up of 441 ± 220 days. Results LVEF increased significantly in both two groups (group 1: 26.2 ± 4.8% to 32.4 ± 8.5%; p < 0.001; group 2: 38.2 ± 2.5% to 44.4 ± 9.6%; p < 0.001). However, statistical analysis of first and second LVEF measurement by means of a LOWESS regression and with an appropriate correction of the regression towards the mean effect revealed only a moderate increase of the mean LVEF from 35 to 37% (p < 0.001) with a large interindividual variation. Conclusions The impact of early revascularization on LVEF appears to be low in the majority of post-MI heart failure patients. Owing to the high variability, a single measurement may not be reliable enough to justify a decision on ICD indication.http://link.springer.com/article/10.1186/s13104-017-2562-4Myocardial infarctionHeart failureCardioverter-defibrillatorRegression toward the mean |
spellingShingle | Rona Reibis Annett Salzwedel Klaus Bonaventura Heinz Völler Karl Wegscheider Improvement of left ventricular ejection fraction in revascularized postmyocardial patients: indication for statistical fallacy BMC Research Notes Myocardial infarction Heart failure Cardioverter-defibrillator Regression toward the mean |
title | Improvement of left ventricular ejection fraction in revascularized postmyocardial patients: indication for statistical fallacy |
title_full | Improvement of left ventricular ejection fraction in revascularized postmyocardial patients: indication for statistical fallacy |
title_fullStr | Improvement of left ventricular ejection fraction in revascularized postmyocardial patients: indication for statistical fallacy |
title_full_unstemmed | Improvement of left ventricular ejection fraction in revascularized postmyocardial patients: indication for statistical fallacy |
title_short | Improvement of left ventricular ejection fraction in revascularized postmyocardial patients: indication for statistical fallacy |
title_sort | improvement of left ventricular ejection fraction in revascularized postmyocardial patients indication for statistical fallacy |
topic | Myocardial infarction Heart failure Cardioverter-defibrillator Regression toward the mean |
url | http://link.springer.com/article/10.1186/s13104-017-2562-4 |
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