CHARACTERISTICS OF PATIENTS ADMITTED TO H OSPITAL FOR MYOCARDIAL-INFARCTION IN FRANCE WITH RESPECT TO LEFT-VENTRICULAR FUNCTION - RESULTS OF THE USIK STUDY

Patients admitted in coronary care units, in november 1995, for confir med acute myocardial infarction within 48 hours of symptoms onset were included in this study. The choice of measurement of left ventricular ejection fraction (LVEF) was left to the physician in charge. Only in vestigations performed within the first 8 days were taken into conside ration, In cases with multiple investigations, the following order of preference was applied : a) angiographic LVEF b) isotopic LVEF c) echo cardiographic ejection fraction by Simpson's method, d) echocardiograp hic ejection fraction by Berning's method, e) semi-quantitative visual echocardiographic evaluation. 2 563 patients were included (1 827 mal es and 736 females, mean age 67 years). A quantitative evaluation of L VEF was obtained in 1 477 patients (57 %) whereas 2 053 patients (80 % ) underwent at least a semi-quantitative evaluation. The average LVEF was 50 % and 17 % of patients had an ejection fraction less than or eq ual to 35 %. Patients with LVEF less than or equal to 35 % were older, less likely males, non smokers and diabetics. Prior heart failure, pr evious myocardial infarction and anterior location in infarction were more frequent. Heart failure was more frequent in patients with LVEF l ess than or equal to 35 % (75 vs 23 %, p < 0.001). One hundred and nin ety-seven patients (7.7 %) died in the five first days following the o nset of symptoms. A left ventricular ejection fraction 35 % multiplied the risk of death by 8.1 (Confidence interval : 5.7-11.4, 0.001). The presence of clinical heart failure increased the risk even more.