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Measurement of Ejection Fraction After Myocardial Infarction in the Population: Implications

Recent data underscored the association between the specialty of the ambulatory physician and the delivery of care among MI survivors. The present study extends these findings by demonstrating a positive association between the involvement of a cardiologist as a care provider and the measurements of LVEF among all consecutive patients from a geographically defined population admitted with acute MI irrespective of their hospital outcomes, such that the results are generalizable to all MI patients, not only survivors.
The ascertainment of LVEF after MI enhances risk stratification and optimizes the use of evidence-based therapies. With regards to risk stratification, assessment of LV function helps predict cardiac events after MI in both the before-reperfusion and reperfusion eras. To this end, as reported in the experience of the present group and others, the EF provides information incremental to that of commonly used post-MI risk stratification approaches, and its value is underscored in the 1999 updated ACC/AHA guidelines for the management of patients with acute MI.
Knowledge of LVEF is associated with more frequent use of ACE inhibitors after MI, and may contribute to increase the use of (3-blockers, which is currently not optimal. To this end, the frequency of the measurement of LVEF after MI has been considered as a process-of-care quality-performance measure, an approach supported by the present data.

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