Acute Myocardial Infarction Quality Assurance Project

Background

Patients suffering a myocardial infraction (MI) may have from minimal to extensive myocardial damage. While severe left ventricular (LV) dysfunction that persists beyond the initial 2-3 months of an MI is a predictor of sudden death, the prognostic significance of less severe LV dysfunction after MI is unclear.

There is significant clinical value in quantifying LV function after the recovery phase of an MI. This information is vital in guiding the breadth and duration of therapies known to improve prognosis (beta-blockers, ACE inhibitors, angiotensin blockers, anticoagulants, and others). Further, it will identify patients in whom other therapies, such as an implantable cardioverter defibrillator (ICD), are recommended. Yet, no guidelines to guide clinical decision making in terms of collecting follow-up ejection fraction (EF) data in such patients who do not also have overt heart failure.

Purpose The Acute Myocardial Infarction Quality Assurance (AMIQA) project proposes to

1. document clinical practice by collecting data on the proportion of patients with initial LV dysfunction after MI without a follow-up EF assessment arranged,
2. collect follow-up EF data in patients with initial LV dysfunction post-MI and evaluate the prognostic significant of EF early and late after MI as well as factors associated with the change in value, and
3. educate physicians regarding the importance of EF reassessment after MI.