Format

Send to

Choose Destination
See comment in PubMed Commons below
Ann Intern Med. 1994 Nov 15;121(10):750-6.

A clinical rule to predict preserved left ventricular ejection fraction in patients after myocardial infarction.

Author information

1
Massachusetts General Hospital, Boston.

Abstract

OBJECTIVE:

To derive and validate a clinical prediction rule that identifies patients after myocardial infarction who have preserved left ventricular systolic function.

DESIGN:

Retrospective analysis of a prospective cohort study, with a derivation set to generate a clinical prediction rule and a validation set to test the prediction rule.

SETTING:

Urban tertiary care hospital.

PATIENTS:

314 consecutive patients admitted with myocardial infarction who had one or more of the following tests to determine left ventricular ejection fraction: transthoracic echocardiography, contrast left ventriculography, or radionuclide ventriculography.

MEASUREMENTS:

Left ventricular ejection fractions were determined by transthoracic echocardiography, contrast left ventriculography, and gated blood pool scan.

RESULTS:

Multivariate analysis of patients in the derivation set yielded the following rule: The left ventricular ejection fraction is predicted to be 40% or more in patients who have 1) an interpretable electrocardiogram, 2) no previous Q-wave myocardial infarction, 3) no history of congestive heart failure, and 4) an index myocardial infarction that is not a Q-wave anterior infarction. In the derivation and the validation sets, the positive predictive value of the prediction rule was more than 0.98.

CONCLUSIONS:

A simple clinical prediction rule using easily obtained historical and electrocardiographic data reliably identifies a substantial percentage of patients after myocardial infarction (40% in our hospital) who are likely to have preserved left ventricular systolic function. If validated in other patient populations, application of this prediction rule in clinical practice could result in a substantial decrease in the cost of treating uncomplicated myocardial infarction.

PMID:
7944052
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems
    Loading ...
    Support Center