title: Predicting Persistent Left Ventricular Dysfunction Following Myocardial Infarction: The PREDICTS Study.
abstract: BACKGROUND
  Persistent severe left ventricular (LV) systolic dysfunction after myocardial infarction (MI) is associated with increased mortality and is a class I indication for implantation of a cardioverter-defibrillator.
  
  
  OBJECTIVE
  This study developed models and assessed independent predictors of LV recovery to >35% and ≥50% after 90-day follow-up in patients presenting with acute MI and severe LV dysfunction.
  
  
  METHODS
  Our multicenter prospective observational study enrolled participants with ejection fraction (EF) of ≤35% at the time of MI (n = 231). Predictors for EF recovery to >35% and ≥50% were identified after multivariate modeling and validated in a separate cohort (n = 236).
  
  
  RESULTS
  In the PREDICTS (PREDiction of ICd Treatment Study) study, 43% of patients had persistent EF ≤35%, 31% had an EF of 36% to 49%, and 26% had an EF ≥50%. The model that best predicted recovery of EF to >35% included EF at presentation, length of stay, prior MI, lateral wall motion abnormality at presentation, and peak troponin. The model that best predicted recovery of EF to ≥50% included EF at presentation, peak troponin, prior MI, and presentation with ventricular fibrillation or cardiac arrest. After predictors were transformed into point scores, the lowest point scores predicted a 9% and 4% probability of EF recovery to >35% and ≥50%, respectively, whereas profiles with the highest point scores predicted an 87% and 49% probability of EF recovery to >35% and ≥50%, respectively.
  
  
  CONCLUSIONS
  In patients with severe systolic dysfunction following acute MI with an EF ≤35%, 57% had EF recovery to >35%. A model using clinical variables present at the time of MI can help predict EF recovery.
authors.affiliation: Department of Medicine, Division of Cardiology, University of California San Francisco, San Francisco, California.
authors.forename: Gabriel C
authors.initials: GC
authors.lastname: Brooks
authors.affiliation: Department of Medicine, Division of Cardiology, University of California San Francisco, San Francisco, California.
authors.forename: Byron K
authors.initials: BK
authors.lastname: Lee
authors.affiliation: Department of Medicine, Division of Cardiology, University of California San Francisco, San Francisco, California.
authors.forename: Rajni
authors.initials: R
authors.lastname: Rao
authors.affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California.
authors.forename: Feng
authors.initials: F
authors.lastname: Lin
authors.affiliation: Department of Medicine, Ochsner Medical Center, New Orleans, Louisiana; Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Morin
authors.affiliation: Department of Medicine, Hartford Hospital, Hartford, Connecticut.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Zweibel
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Alfred E
authors.initials: AE
authors.lastname: Buxton
authors.affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Pletcher
authors.affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California.
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.affiliation: Department of Medicine, Division of Cardiology, University of California San Francisco, San Francisco, California. Electronic address: jeffrey.olgin@ucsf.edu.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Olgin
mesh_terms: D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology*; D015996:Survival Rate / Q000639:trends; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D020257:Ventricular Remodeling
keywords: heart failure; remodeling; risk assessment; ventricular ejection fraction