Global longitudinal strain in long-term risk prediction after acute coronary syndrome : an investigation of added prognostic value to ejection fraction
Lenell, Joel ; Lindahl, Bertil ; Erlinge, David LU
; Jernberg, Tomas
; Spaak, Jonas
and Baron, Tomasz
(2024)
In Clinical Research in Cardiology
- Abstract
Aims: This study aimed to investigate the additional value of global longitudinal strain (GLS) on top of left ventricular ejection fraction (LVEF) in long-term risk prediction of combined death and heart failure (HF) re-hospitalization after acute coronary syndrome (ACS). Method and results: This retrospective study included patients admitted with ACS between 2008 and 2014 from the three participating university hospitals. LVEF and GLS were assessed at a core lab from images acquired during the index hospital stay. Their prognostic value was studied with the Cox proportional hazards model (median follow-up 6.2 years). A nested model comparison was performed with C-statistics. A total of 941 patients qualified for multivariable analysis... (More)
Aims: This study aimed to investigate the additional value of global longitudinal strain (GLS) on top of left ventricular ejection fraction (LVEF) in long-term risk prediction of combined death and heart failure (HF) re-hospitalization after acute coronary syndrome (ACS). Method and results: This retrospective study included patients admitted with ACS between 2008 and 2014 from the three participating university hospitals. LVEF and GLS were assessed at a core lab from images acquired during the index hospital stay. Their prognostic value was studied with the Cox proportional hazards model (median follow-up 6.2 years). A nested model comparison was performed with C-statistics. A total of 941 patients qualified for multivariable analysis after multiple imputation of missing baseline covariables. The combined outcome was reached in 17.7% of the cases. Both GLS and LVEF were independent predictors of the combined outcome, hazard ratio (HR) 1.068 (95% CI 1.017–1.121) and HR 0.980 (95% CI 0.962–0.998), respectively. The C-statistic increased from 0.742 (95% CI 0.702–0.783) to 0.749 (95% CI 0.709–0.789) (P = 0.693) when GLS entered the model with clinical data and LVEF. Conclusion: GLS emerged as an independent long-term risk predictor of all-cause death and HF re-hospitalization. However, there was no significant incremental predictive value of GLS when LVEF was already known. Graphical Abstract: (Figure presented.)
(Less)
- author
- Lenell, Joel
; Lindahl, Bertil
; Erlinge, David
LU
; Jernberg, Tomas
; Spaak, Jonas
and Baron, Tomasz
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- epub
- subject
- keywords
- ACS, GLS, LVEF, Myocardial infarction, Prognosis, SWEDEHEART
- in
- Clinical Research in Cardiology
- publisher
- Steinkopff
- external identifiers
-
- pmid:38526603
- scopus:85188531508
- ISSN
- 1861-0684
- DOI
- 10.1007/s00392-024-02439-w
- language
- English
- LU publication?
- yes
- id
- ec047635-b808-4ae9-a26a-6459111ef748
- date added to LUP
- 2024-04-12 10:01:25
- date last changed
- 2024-06-07 16:15:07
@article{ec047635-b808-4ae9-a26a-6459111ef748,
abstract = {{<p>Aims: This study aimed to investigate the additional value of global longitudinal strain (GLS) on top of left ventricular ejection fraction (LVEF) in long-term risk prediction of combined death and heart failure (HF) re-hospitalization after acute coronary syndrome (ACS). Method and results: This retrospective study included patients admitted with ACS between 2008 and 2014 from the three participating university hospitals. LVEF and GLS were assessed at a core lab from images acquired during the index hospital stay. Their prognostic value was studied with the Cox proportional hazards model (median follow-up 6.2 years). A nested model comparison was performed with C-statistics. A total of 941 patients qualified for multivariable analysis after multiple imputation of missing baseline covariables. The combined outcome was reached in 17.7% of the cases. Both GLS and LVEF were independent predictors of the combined outcome, hazard ratio (HR) 1.068 (95% CI 1.017–1.121) and HR 0.980 (95% CI 0.962–0.998), respectively. The C-statistic increased from 0.742 (95% CI 0.702–0.783) to 0.749 (95% CI 0.709–0.789) (P = 0.693) when GLS entered the model with clinical data and LVEF. Conclusion: GLS emerged as an independent long-term risk predictor of all-cause death and HF re-hospitalization. However, there was no significant incremental predictive value of GLS when LVEF was already known. Graphical Abstract: (Figure presented.)</p>}},
author = {{Lenell, Joel and Lindahl, Bertil and Erlinge, David and Jernberg, Tomas and Spaak, Jonas and Baron, Tomasz}},
issn = {{1861-0684}},
keywords = {{ACS; GLS; LVEF; Myocardial infarction; Prognosis; SWEDEHEART}},
language = {{eng}},
publisher = {{Steinkopff}},
series = {{Clinical Research in Cardiology}},
title = {{Global longitudinal strain in long-term risk prediction after acute coronary syndrome : an investigation of added prognostic value to ejection fraction}},
url = {{http://dx.doi.org/10.1007/s00392-024-02439-w}},
doi = {{10.1007/s00392-024-02439-w}},
year = {{2024}},
}