Evidence map›Paper›PMID 35950269›Full record

ArticleESC heart failure2022

Prevalence and prognostic implications of reduced left ventricular ejection fraction among patients with STEMI in India.

Michael J Hendrickson, Sameer Arora, Muthiah Vaduganathan, Gregg C Fonarow, Girish Mp, Ankit Bansal, Vishal Batra, Shekhar Kunal, Deepak L Bhatt, Mohit Gupta and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.1field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 2 countries.

Michael J HendricksonMassachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Sameer AroraDivision of Cardiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Muthiah VaduganathanBrigham and Women's Hospital Heart and Vascular Institute, Harvard Medical School, Boston, MA, USA.
Gregg C FonarowDivision of Cardiology, University of California Los Angeles, Los Angeles, CA, USA.
Girish MpGB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
Ankit BansalGB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
Vishal BatraGB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
Shekhar KunalGB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
Deepak L BhattBrigham and Women's Hospital Heart and Vascular Institute, Harvard Medical School, Boston, MA, USA.
Mohit GuptaGB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
Arman QamarSection of Interventional Cardiology and Vascular Medicine, NorthShore University Health System, University of Chicago Pritzker School of Medicine, Evanston, IL, USA.
Govind Ballabh Pant Hospital · INZero to Three · USBrigham and Women's Hospital · USHarvard University · USMassachusetts General Hospital · USUniversity of California, Los Angeles · USUniversity of North Carolina at Chapel Hill · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo describe clinical characteristics and outcomes for those with STEMI and reduced left ventricular ejection fraction (LVEF) in low-income and middle-income countries (LMICs). METHODS AND

resultsAdults presenting with STEMI to two government-owned tertiary care centres in Delhi, India were prospectively enrolled in the North India ST-elevation myocardial infarction (NORIN-STEMI) registry. LVEF was evaluated at presentation and clinical characteristics were compared across LVEF categories. Overall, 3597 patients were included, of whom 468 (13%) had LVEF >50%, 1482 (41%) had mildly reduced LVEF (40-49%), 1357 (38%) had moderately reduced LVEF (30-39%), and 290 (8%) had severely reduced LVEF (<30%). Presentation delay >24 h, prior MI, and hyperlipidaemia were associated with decreasing LVEF category. Although most patients with reduced LVEF were discharged on appropriate guideline-directed therapies, adherence at 1 year was low (ACE inhibitor/ARB 91% to 41%, beta blocker 98% to 78%, aldosterone receptor antagonist 69% to 6%). After multivariable adjustment, a Cox regression model showed moderately reduced LVEF (HR 1.77, 95% CI 1.20, 2.60) and severely reduced LVEF (HR 3.63, 95% CI 2.41, 5.48) were associated with increased risk of all-cause mortality compared with LVEF ≥50%.

conclusionsOn presentation for STEMI, almost 90% of NORIN-STEMI participants had at least mildly reduced LVEF and almost half had LVEF <40%. Patients with LVEF <40% had significantly higher risk of mortality at 1 year, and adherence to guideline-directed therapies at 1 year was poor. Systematic initiatives to improve access to timely revascularization and guideline-directed therapies are essential in advancing STEMI care in LMICs.

Indexed as

ST Elevation Myocardial InfarctionAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsHumansPrevalencePrognosisStroke VolumeVentricular Function, LeftAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor Antagonistsatherosclerotic cardiovascular diseaseheart failureleft ventricular dysfunctionNORIN-STEMIST-elevation myocardial infarction

Identifiers

PMID35950269
PMCPMC9773730
OpenAlexW4291020666

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.