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      Usefulness of Predischarge Echocardiographic Criteria in Predicting Complications following Acute Myocardial Infarction

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          In 103 patients who recovered from an acute myocardial infarction (AMI) we evaluated the usefulness of predischarge clinical, routine laboratory and M-mode echocardiographic (echo) criteria in predicting cardiac complications during a period of 12–41 months (25.0 ± 10.7 months) follow-up. The echo parameters evaluated were: left ventricular diastolic diameter, left ventricular percent fractional shortening and the mitral valve E point septal separation. The combination of these three echo criteria was defined as an echo-index, which was considered abnormal if at least two of the three single parameters were pathological. Congestive heart failure occurred in 35 (34%) patients, with significantly higher prevalence among those older than 65 years, with previous AMI and with predischarge findings of heart failure. However, the sensitivity of these clinical parameters was unsatisfactory (34–69%). The sensitivity, specificity and positive predictive value of the echo-index for future heart failure were 89, 88 and 80%, respectively. Chest pain prior to hospital discharge was the only criteria predicting high risk of reinfarction (p = 0.001). The risk of cardiac death was related to age older than 65 years (p = 0.03) and an abnormal echo-index (p = 0.01). The overall mortality rate was 13%, but only 6% among those with normal and 26% among those with pathologic echo-index. In conclusion, in patients who recovered from an AMI, a simple and easily measured echo-index was superior to most clinical and routine laboratory criteria in predicting future heart failure and cardiac death.

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          Author and article information

          S. Karger AG
          11 November 2008
          : 73
          : 3
          : 139-146
          The Heiden Department of Cardiology, Bikur Cholim Hospital and Hebrew University-Hadassah Medical School, Jerusalem, Israel
          173997 Cardiology 1986;73:139–146
          © 1986 S. Karger AG, Basel

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          Pages: 8
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