Predictive Factors for the Recovery of Left Ventricular Dysfunction in Patients with Acute Myocardial Infarction

ABSTRACT

BACKGROUND AND OBJECTIVES: The left ventricular ejection fraction (LVEF) is known to be a significant prognostic factor for patients with acute myocardial infarction (AMI). The aim of this study was to investigate clinical or therapeutic factors associated with the recovery of a low LVEF for patients with AMI. SUBJECTS AND METHODS: From January to December 2004, we enrolled 89 patients (mean age 62.5+/-10.6 years, 43 males and 26 females) with AMI and who had a LVEF less than 50%. Forty five patients whose LVEF improved more than 10% were classified as group I (mean age 62.4+/-10.4 years, 34 males and 11 females) and 44 patients whose LVEF was not changed or decreased were classified as group II (mean age 62.3+/-10.9 years, 29 males and 15 females). The clinical variables, including risk factors and the pain-to-door time, the biochemical markers of myocardial injury, the coronary angiographic findings and the treatment-related variables, were compared between the two groups. RESULTS: The cardiovascular risk factors were not different between the groups. The location of infarction, the success rate of percutaneous coronary intervention and the coronary angiographic lesion morphologies were not different between the groups. However, the pain-to-door time was significantly shorter in group I than in group II (6.0+/-9.5 vs 22.4+/-7.5 hours, respectively, p=0.046). Improved control of risk factors was not associated with the recovery of LV function. The use of beta-blocker, statin, anti-platelet agents, vasodilators and diuretics were not different between the groups. However, the use of angiotensin converting enzyme inhibitor (ACEI) was more common in group I than group II (79.3% vs 47.4%, respectively, p=0.03). CONCLUSION: A shorter pain-to-door time and the use of ACEI were significant predictors of the recovery of LV dysfunction for patients with AMI.