{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T17:16:35Z","timestamp":1780506995773,"version":"3.54.1"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T00:00:00Z","timestamp":1725580800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010230","name":"Queensland Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010230","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>While left ventricular ejection fraction (LVEF) is the primary variable utilized for prognosis following myocardial infarction (MI), it is relatively indiscriminate for survival in patients with mildly reduced (&gt;\u00a040%) or preserved LVEF (&gt;\u00a050%). Improving risk stratification in patients with mildly reduced or preserved LVEF remains an unmet need, and could be achieved by using a combination approach using prognostically validated measures of left\u2010ventricular (LV) size, geometry, and function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study was to compare the prognostic utility of a Combined Echo\u2010Score for predicting all\u2010cause (ACM) and cardiac mortality (CM) following MI to LVEF alone, including the sub\u2010groups with LVEF\u00a0&gt;\u00a040% and LVEF\u00a0&gt;\u00a050%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective data on 3094 consecutive patients with MI from 2013 to 2021 who had inpatient echocardiography were included, including both patients with ST\u2010elevation MI (<jats:italic>n<\/jats:italic>\u00a0=\u00a0869 [28.1%]) and non\u2010ST\u2010elevation MI (<jats:italic>n<\/jats:italic>\u00a0=\u00a02225 [71.9%]). Echo\u2010Score consisted of LVEF\u00a0&lt;\u00a040% (2 points) or LVEF\u00a0&lt;\u00a050% (1 point), and 1 point each for left atrial volume index\u00a0&gt;\u00a034\u00a0mL\/m<jats:sup>2<\/jats:sup>, septal E\/e\u02b9\u00a0&gt;\u00a015, abnormal LV mass\u2010index, tricuspid regurgitation velocity\u00a0&gt;\u00a02.8\u00a0m\/s, and abnormal LV end\u2010systolic volume\u2010index. Simple addition was used to derive a score out of 7.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At a median follow\u2010up of 4.5 years there were 445 deaths (130 cardiac deaths). On Cox proportional\u2010hazards multivariable analysis incorporating significant clinical and echocardiographic predictors, Echo\u2010Score was an independent predictor of both ACM (HR 1.34, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) and CM (HR 1.59, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). Inter\u2010model comparisons of model <jats:italic>\ud835\uded8<jats:sup>2<\/jats:sup><\/jats:italic>, Harrel's C and Somer's D, and Receiver operating curves confirmed the superior prognostic value of Echo\u2010Score for both endpoints compared to LVEF. In the subgroups with LVEF\u00a0&gt;\u00a040% and LVEF\u00a0&gt;\u00a050%, Echo\u2010Score was similarly superior to LVEF for predicting ACM and CM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An Echo\u2010Score composed of prognostically validated LV parameters is superior to LVEF alone for predicting survival in patients with MI, including the subgroups with mildly reduced and preserved LVEF. This could lead to improved patient risk stratification, better\u2010targeted therapies, and potentially more efficient use of device therapies. Further studies should be considered to define the benefit of further investigation and treatment in high\u2010risk subgroups.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15922","type":"journal-article","created":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T08:05:09Z","timestamp":1725609909000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Novel combined echocardiographic score comprising prognostically validated measures of left ventricular size and function to predict long\u2010term survival following myocardial infarction: A proposal to improve risk stratification"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8681-9425","authenticated-orcid":false,"given":"Sandhir B.","family":"Prasad","sequence":"first","affiliation":[{"name":"Department of Cardiology Royal Brisbane and Women's Hospital  Herston Australia"},{"name":"Faculty of Medicine University of Queensland  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