A prospective study found impaired left ventricular function predicted job retirement after acute myocardial infarction.
OBJECTIVE
Impaired left ventricular function is associated with poor prognosis after acute myocardial infarction (MI). It might be hypothesized that impaired left ventricular function would also affect work outcome; however, no existing data address this hypothesis. This study examines whether reduced left ventricular systolic function had any influence on the 4-year retirement rate after acute MI.


METHODS
We conducted a prospective study including 242 working-active patients with MI. Left ventricular ejection fraction (LVEF) was estimated by echocardiography during hospital admission. Data about work outcome after 4 years were collected by telephone interviews.


RESULTS
Fifty percent were retired by the end of follow-up. Moderately or severely reduced LVEF (35%) increased the risk of retirement almost twofold (risk ratio RR=1.8, 95% confidence interval CI=1.3-2.5). After adjusting for confounding factors, reduced LVEF was an independent predictor of retirement. Based on a stratified analysis, being female (RR=3.90, 95% CI=1.18-12.62) or having heavy physical job demands (RR=3.83, 95% CI=1.02-14.30) had a more pronounced impact on retirement for patients with LVEF 35%, compared with patients with better left ventricular function.


CONCLUSIONS
We conclude that impaired left ventricular systolic function is a prognostic determinant of retirement from the job market after acute MI.
Nielsen
Finn E
FE
Department of Internal Medicine, Viborg Hospital, Heibergs Allé, DK-8800 Viborg, Denmark. finn.nielsen@v-ks.dk
Sørensen
Henrik T
HT
Skagen
Knud
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality; D005082:Physical Exertion; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012179:Retirement / Q000706:statistics & numerical data*; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000534:rehabilitation*