Contemporary data on patients with left ventricular dysfunction after myocardial infarction (MI) are scarce. In this nationwide Swedish study (49,564 patients from the SWEDEHEART registry, first MI, 2011-2018, no prior heart failure), patients were stratified by degree of LV dysfunction. Compared with normal ejection fraction (≥50%), patients with severely reduced EF (<30%) far more often had dyspnoea (32.3% vs 5.6%; OR 7.45), were more often readmitted (48.1% vs 31.2%) and on sick leave (26.6% vs 9.5%); chest pain and quality of life did not differ. Patients with EF <30% less often took part in education programmes, physiotherapy and regular physical activity. Reduced pump function after infarction is thus associated with a high symptom burden and poorer uptake of secondary prevention — an important focus for aftercare.
There is a lack of contemporary data describing patients with left ventricular (LV) systolic dysfunction post myocardial infarction (MI) in terms of symptom burden and secondary prevention measures. The aim of this study was to describe patients with various degrees of LV systolic dysfunction after a first MI, their symptom burden, quality of life and adherence to recommended secondary prevention measures in a nationwide patient material.
Patients (n=49 564) registered in the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease registry between 2011 and 2018, diagnosed with a first acute MI, discharged alive and with no previous heart failure, were stratified by degree of LV systolic dysfunction.
Compared with patients with normal ejection fraction (EF≥50%), patients with a reduced EF (<30%) more often experienced shortness of breath (32.3% vs 5.6%, adjusted OR (95% CI): 7.45 (6.22 to 8.92)), had more often been readmitted (48.1% vs 31.2%, 1.87 (1.61 to 2.19)) and were more often on sick leave (26.6% vs 9.5%, 3.35 (2.45 to 4.58)), whereas there were no significant differences regarding chest pain and quality of life at the follow-up visit after 11–13 months. Patients with EF <30% had participated in education programme (44.9% vs 55.5%, 0.70 (0.60 to 0.81)) and physical therapy (11.3% vs 14.9%, 0.68 (0.58 to 0.79)) and have been physically active at least 30 min per day for at least 5 days per week (35.5% vs 40.2%, 0.86 (0.73 to 1.01)) to a lesser extent.
Contemporary representative data show that LV systolic dysfunction after MI is associated with a very high symptom burden and worse secondary prevention after 11–13 months.
