Document Detail

Estimating left ventricular ejection fraction after myocardial infarction by various clinical parameters.
MedLine Citation:
PMID:  3400597     Owner:  NLM     Status:  MEDLINE    
The clinical predictors of left ventricular (LV) ejection fraction (EF) were determined in 760 survivors of an acute myocardial infarction (AMI). LVEF was dichotomized at less than or equal to 0.40 (n = 269) and greater than 0.04 (n = 491). Logistic regression showed that 4 of 20 preselected, clinically meaningful variables were strong and independent (p less than 0.001) predictors of LVEF less than or equal to 0.40. Independent variables together with their odds ratio (odds of having a LVEF less than or equal to 0.40 with factor present to odds with factor absent) in order of decreasing importance were: anterior AMI (4.7), congestion on chest x-ray (2.9), previous AMI (2.3) and creatine kinase greater than 1,000 U (2.1). There was a stepwise decrease in LVEF and an increase in the proportion of patients with a low LVEF for each additional clinical variable. A general estimate of LVEF was made by simply considering the total number of clinical factors present. The presence of 0 or 1 clinical variable (n = 466) predicted a high LVEF (greater than 0.40) with an accuracy of 80%. Two or more variables (n = 294) predicted a low LVEF (less than or equal to 0.40) with an accuracy of 60%. The overall predictive accuracy was 72%. Clinically significant major misclassifications were rare (less than 10%). Readily obtainable clinical variables provide the clinician with a useful bedside method of estimating LVEF after AMI.
R F McNamara; E Carleen; A J Moss
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  62     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1988 Aug 
Date Detail:
Created Date:  1988-08-26     Completed Date:  1988-08-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  192-6     Citation Subset:  AIM; IM    
Department of Cardiology, University of Rochester, School of Medicine and Dentistry, New York.
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MeSH Terms
Heart Function Tests
Middle Aged
Myocardial Infarction / diagnosis,  physiopathology*
Regression Analysis
Risk Factors
Stroke Volume*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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