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Heart failure with mid-range ejection fraction and the effect of β-blockers after acute myocardial infarction

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Author(s)
Pil Sang SongMijoo KimSeok-Woo SeongJae-Hyeong ParkSi Wan ChoiJoo-Yong HahnHyeon-Cheol GwonSeung-Ho HurSeung-Woon RhaChang-Hwan YoonMyung Ho JeongIn-Whan SeongJin-Ok Jeong
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
Heart Vessels
Issued Date
2021
Volume
36
Keyword
Heart failure with mid-range ejection fractionAcute myocardial infarctionβ-blockers
Abstract
There is currently an ongoing debate about the 'grey area' of heart failure with mid-range ejection fraction (HFmrEF). We evaluated characteristics, prognosis, and the effect of β-blockers on clinical outcomes in patients with HFmrEF after acute myocardial infarction (AMI). We included a total of 10,785 patients and divided them into three groups: EF 40–49% (HFmrEF; n = 2717; reference); EF < 40% (reduced EF [HFrEF]; n = 1194); and EF ≥ 50% (preserved EF [HFpEF]; n = 6874). The primary outcome was 2-year all-cause mortality. HFmrEF was intermediate between HFrEF and HFpEF for baseline characteristics. The risk of all-cause mortality was lower for HFmrEF patients compared to HFrEF patients (adjusted hazard ratio [HR] 0.710; 95% confidence interval [CI] 0.544–0.927; P = 0.012). However, HFmrEF patients tended to be at higher risk for 2-year all-cause mortality than HFpEF patients (adjusted HR 1.235; 95% CI 0.989–1.511; P = 0.090). β-blockers were associated with reductions in all-cause mortality for the entire cohort (adjusted HR 0.760; 95% CI 0.592–0.975; P = 0.031). β-blockers were effective in patients with HFrEF (adjusted HR 0.667; 95% CI 0.471–0.944; P = 0.022), tended to be effective in patients with HFmrEF (adjusted HR 0.665; 95% CI 0.426–1.038; P = 0.072), but not effective in patients with HFpEF (adjusted HR 0.852; 95% CI 0.548–1.326; P = 0.478; interaction P = 0.026). In conclusion, clinical profiles and prognosis of patients with post-AMI HFmrEF are largely intermediate between HFrEF and HFpEF. β-blockers reduced or tended to reduce 2-year all-cause mortality in patients with HFrEF or HFmrEF, respectively, but not those with HFpEF after AMI.
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine (의과대학)
Citation
Pil Sang Song et al. (2021). Heart failure with mid-range ejection fraction and the effect of β-blockers after acute myocardial infarction. Heart Vessels, 36, 1848–1855. doi: 10.1007/s00380-021-01876-1
Type
Article
ISSN
1615-2573
Source
https://link.springer.com/article/10.1007%2Fs00380-021-01876-1
DOI
10.1007/s00380-021-01876-1
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43800
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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