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Left ventricular assessment in myocardial infarction: the VALIANT registry.

Publication ,  Journal Article
Hernandez, AF; Velazquez, EJ; Solomon, SD; Kilaru, R; Diaz, R; O'Connor, CM; Ertl, G; Maggioni, AP; Rouleau, J-L; van Gilst, W; Pfeffer, MA ...
Published in: Arch Intern Med
October 10, 2005

BACKGROUND: How often echocardiography and cardiac catheterization are used to evaluate left ventricular (LV) function in patients with myocardial infarction (MI) and how they are associated with quality of care is unknown. METHODS: Patients with MI in the Valsartan in Acute Myocardial Infarction (VALIANT) registry were divided into those with (n = 1423) and without (n = 3968) heart failure (HF), and the use of either echocardiography or cardiac catheterization for LV assessment in each group was compared along with associated baseline characteristics. We evaluated the association between LV assessment and discharge medications. Using a multivariable model with a propensity analysis, we evaluated the association of LV assessment with in-hospital outcomes. RESULTS: Of the patients with HF, 322 (22.6%) had no LV assessment. Patients with HF with LV assessment were discharged more frequently under treatment with aspirin (81.3% vs 70.0%; P<.001), beta-blockers (65.6% vs 56.4%; P = .008), clopidogrel (30.4% vs 14.0%; P<.001), and statins (45.9% vs 34.2%; P<.001). Patients without HF who underwent LV assessment were discharged more frequently under treatment with an angiotensin-converting enzyme inhibitor (53.8% vs 41.5%; P<.001). After adjustment for regional use, other covariates, and revascularization, LV assessment was associated with lower in-hospital mortality in patients with HF (adjusted odds ratio [OR], 0.45; P<.001) and in patients without HF (adjusted OR, 0.30; P<.001). After excluding deaths during the first 2 days, LV assessment remained associated with lower mortality in patients with HF (adjusted OR, 0.59; P = .03) and in patients without HF (adjusted OR, 0.41; P<.001). CONCLUSION: Left ventricular assessment was frequently not performed during the in-hospital stay of patients with acute MI, including those with clinical HF, and its use was associated with better quality of care.

Duke Scholars

Published In

Arch Intern Med

DOI

ISSN

0003-9926

Publication Date

October 10, 2005

Volume

165

Issue

18

Start / End Page

2162 / 2169

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Valsartan
  • Valine
  • Tetrazoles
  • Outcome Assessment, Health Care
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • General & Internal Medicine
 

Citation

APA
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ICMJE
MLA
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Hernandez, A. F., Velazquez, E. J., Solomon, S. D., Kilaru, R., Diaz, R., O’Connor, C. M., … VALIANT Registry, . (2005). Left ventricular assessment in myocardial infarction: the VALIANT registry. Arch Intern Med, 165(18), 2162–2169. https://doi.org/10.1001/archinte.165.18.2162
Hernandez, Adrian F., Eric J. Velazquez, Scott D. Solomon, Rakhi Kilaru, Rafael Diaz, Christopher M. O’Connor, George Ertl, et al. “Left ventricular assessment in myocardial infarction: the VALIANT registry.Arch Intern Med 165, no. 18 (October 10, 2005): 2162–69. https://doi.org/10.1001/archinte.165.18.2162.
Hernandez AF, Velazquez EJ, Solomon SD, Kilaru R, Diaz R, O’Connor CM, et al. Left ventricular assessment in myocardial infarction: the VALIANT registry. Arch Intern Med. 2005 Oct 10;165(18):2162–9.
Hernandez, Adrian F., et al. “Left ventricular assessment in myocardial infarction: the VALIANT registry.Arch Intern Med, vol. 165, no. 18, Oct. 2005, pp. 2162–69. Pubmed, doi:10.1001/archinte.165.18.2162.
Hernandez AF, Velazquez EJ, Solomon SD, Kilaru R, Diaz R, O’Connor CM, Ertl G, Maggioni AP, Rouleau J-L, van Gilst W, Pfeffer MA, Califf RM, VALIANT Registry. Left ventricular assessment in myocardial infarction: the VALIANT registry. Arch Intern Med. 2005 Oct 10;165(18):2162–2169.

Published In

Arch Intern Med

DOI

ISSN

0003-9926

Publication Date

October 10, 2005

Volume

165

Issue

18

Start / End Page

2162 / 2169

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Valsartan
  • Valine
  • Tetrazoles
  • Outcome Assessment, Health Care
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • General & Internal Medicine