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Low ejection fraction documented during cardiac catheterization is significantly associated with long-term, all-cause
Mohammad Reza Movahed1, Sudhakar Sattur
1The Southern Arizona VA Health Care System and University of Arizona Sarver Heart Center, Tucson, AZ 85724, USA. rmova@aol.com
Insights
Reduced ejection fraction (EF) independently predicts 10-year mortality in patients undergoing coronary angiography. This finding highlights EF as a critical prognostic indicator for long-term survival.
Area of Science:
- Cardiology
- Clinical Research
- Public Health
Background:
- Decreased ejection fraction (EF) is a known mortality predictor.
- Long-term outcomes related to EF in patients undergoing ventriculography require further investigation.
- This study examines the association between EF severity and 10-year mortality using a large patient database.
Purpose of the Study:
- To evaluate the association between the severity of ejection fraction impairment and 10-year mortality.
- To determine if decreased EF is an independent predictor of mortality.
- To analyze mortality risk across different degrees of EF reduction.
Main Methods:
- Retrospective analysis of 1,937 patients' angiographic data (1993-1997).
- Definition of decreased EF as <50%.
- Statistical analysis using chi-square tests, Cox survival analysis, and uni-/multivariate models.
Main Results:
- Overall mortality was 22.9%.
- Decreased EF significantly predicted 10-year all-cause mortality (41.7% vs. 21.6% in normal EF).
- Adjusted analysis confirmed EF as an independent predictor, irrespective of ethnicity and other risk factors.
Conclusions:
- Ejection fraction measured during coronary angiography is a robust, independent predictor of 10-year all-cause mortality.
- EF impairment is a critical factor for assessing long-term prognosis in cardiac patients.
- Findings underscore the importance of EF assessment in risk stratification.
Background:
Decreased ejection fraction (EF) has been found to be a strong predictor of mortality. However, this association has not been studied in patients undergoing ventriculography over a long period of time. Using a large database of patients who underwent coronary angiography for clinical reasons, we evaluated any association between severity of EF impairment and 10 year mortality.
Methods:
Retrospective angiographic data of 1,937 patients between 1993 to 1997 from the VA Long Beach Health Care System were studied. Decreased EF was defined as EF<50%. Using chi-square test and Cox survival analysis, we evaluated any association between decreased EF with mortality. Furthermore, we evaluated different degrees of decreased EF with all-cause mortality using uni- and multivariate analysis.
Results:
Total mortality was 22.9% of the cohort. Decreased EF was a strong predictor of death over a period of 10 years. (All-cause mortality occurred in 21.6 % of patients with normal EF vs. 41.7 %, OR 2.59, CI 2.06-3.26, P<.001). After adjustment for left main coronary artery disease, mitral regurgitation, three-vessel coronary disease, and clinical risk factors (diabetes, hypertension, hyperlipidemia, and smoking), decreased EF remained independently associated with all cause-mortality regardless of ethnicity.
Conclusion:
Decreased EF measured during coronary angiography is a strong independent predictor of all-cause mortality over a period of 10 years.
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