Severe Left Ventricular Dysfunction After Acute Myocardial Infarction: A Call for Development of Adequately Targeted Treatments

Since the wide adoption of emergency revascularization, the overall prognosis of acute coronary syndrome (ACS) has grossly improved.1 However, patients with associated heart failure (HF), either preexisting or consequent to the acute ischemic insult, still represent a short-term and long-term high-r...

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Bibliographic Details
Published in:The American journal of cardiology 2023-08, Vol.200, p.213-214
Main Author: Fragasso, Gabriele
Format: Article
Language:English
Subjects:
Acute coronary syndromes
Age
Congestive heart failure
Ejection fraction
Heart attacks
Humans
Ischemia
Medical prognosis
Mortality
Myocardial infarction
Myocardial Infarction - therapy
Patients
Risk
Risk groups
Ventricle
Ventricular Dysfunction, Left - etiology
Ventricular Dysfunction, Left - therapy
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Summary:Since the wide adoption of emergency revascularization, the overall prognosis of acute coronary syndrome (ACS) has grossly improved.1 However, patients with associated heart failure (HF), either preexisting or consequent to the acute ischemic insult, still represent a short-term and long-term high-risk group.2 This might be true for patients with both HF with reduced or preserved ejection fraction: in the Olmstead County Study, HF markedly increased the risk of death after acute myocardial infarction (AMI) and this excess risk was similar regardless of left ventricular (LV) ejection fraction (LVEF) but greater for delayed-onset versus early-onset HF. [...]from a clinical point of view, in the setting of ACS in an organized framework, LVEF evaluation is usually performed. [...]the reported low rate of implementation of an optimal therapeutical strategy in the AMIS Plus Registry appears emblematic, as it may be indeed tied to the clinical conditions of patients contraindicating its adoption, rather than to poor medical attitudes and probably could not be further improved, at least with the presently available drugs.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2023.06.030