Influence of left ventricular dysfunction and age on mortality in patients with symptomatic congestive ischemic left ventricular failure

Abstract

Background: Congestive ventricular failure following after previous myocardial infarction is known to be an independent predictor of outcome, however potentially strong influence of it together with advanced age has not been generally appreciated. The aim of the study was to determine the influence of the left ventricular dysfunction and age on mortality in patients with moderate–severe congestive left ventricular failure following after previous myocardial infarction. Methods: Two hundred and twenty-four post Q-wave myocardial infarction patients with symptomatic congestive heart failure and left ventricular ejection fraction <40% were followed-up for 1–5 years. Kaplan-Meier cumulative mortality curves were plotted to the end of the follow-up to describe trends in mortality in different age and left ventricular ejection fraction and compared by using the log-rank test. Results: Cumulative mortality within 1 year—was 21.0%, in 2 years—40.0%, in 3 years—55.0%, in 4 years—61.0% and in 5 years—65.0%. Probability of death during followup was increased in patients with impaired left ventricular function and advanced age significantly: when left ventricular ejection fraction was <20% the cumulative mortality rate was 82% within 3.5 years and 98% in 5 years. In cases when left ventricular ejection fraction was 20–39% the cumulative mortality was 48 and 65%, respectively (p < 0.05). When patients age was ≥70 years the probability of death within 3.5 years was 82 and 88% in 5 years [...].