Related Experiment Videos
Prognostic significance of angiographically documented left ventricular aneurysm from the Coronary Artery Surgery
Insights
Patients with left ventricular aneurysm have a better prognosis than previously thought. Mortality is linked to age and heart failure severity, not the aneurysm itself.
Area of Science:
- Cardiology
- Clinical Medicine
- Medical Research
Background:
- Left ventricular aneurysm is a known complication of coronary artery disease.
- Prognosis for patients with left ventricular aneurysm is often considered poor.
- Limited data exists on the long-term survival of medically treated patients with left ventricular aneurysm.
Purpose of the Study:
- To evaluate the prognosis of medically treated patients with angiographically defined left ventricular aneurysm.
- To identify predictors of survival in patients with left ventricular aneurysm.
- To compare survival rates of patients with and without left ventricular aneurysm.
Main Methods:
- Analysis of data from 1,136 patients with left ventricular aneurysm from the Coronary Artery Surgery Study (CASS) registry.
- Inclusion of 15,019 patients with coronary artery disease.
- Cox proportional hazards regression analysis to identify survival predictors.
Main Results:
- Patients with left ventricular aneurysm commonly presented with prior myocardial infarction, reduced ejection fraction, absence of angina, and congestive heart failure.
- Cumulative survival rates at 1, 2, 3, and 4 years were 90%, 84%, 79%, and 71%, respectively.
- Left ventricular aneurysm did not independently alter survival when stratified for left ventricular dysfunction and functional impairment.
Conclusions:
- The survival of medically treated patients with left ventricular aneurysm is better than previously recognized.
- Mortality is primarily related to age, left ventricular function, and the clinical severity of heart failure.
- The presence of a left ventricular aneurysm does not independently impact patient survival.
Abstract:
In order to evaluate the prognosis of medically treated patients with angiographically defined left ventricular aneurysm the data available from 1,136 patients with aneurysm (7.6 percent) from 15,019 patients with coronary artery disease in the Coronary Artery Surgery Study (CASS) registry were analyzed. Prior myocardial infarction, reduced ejection fraction, absence of angina and evidence of congestive heart failure were more commonly present in patients with aneurysm. The cumulative survival rates of medically treated patients at 1, 2, 3 and 4 years were 90, 84, 79 and 71 percent, respectively. The Cox analysis of survival indicated that the following variables predicted outcome: age, residual left ventricular function as assessed with angiography, left ventricular end-diastolic pressure, functional impairment due to congestive heart failure, number of vessels diseased, mitral regurgitation and S3 gallop. When survival was stratified for similar degrees of left ventricular dysfunction and functional impairment there was no difference between the survival of patients with aneurysm and that of registry patients without aneurysm. The data from this large population study indicate that the survival of patients with left ventricular aneurysm is better than previously recognized. The mortality in this group is primarily related to age, left ventricular function and clinical severity of heart failure. The presence of an aneurysm does not independently alter survival.