Identifying high risk patients post myocardial infarction with reduced left ventricular function using loop recorders INSPIRE-ELR clinical study

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dc.contributor.authorSingh, Balbiren_US
dc.contributor.authorRao, Hygriv B.en_US
dc.contributor.authorPandurangi, Ulhasen_US
dc.contributor.authorManjunath, C.N.en_US
dc.contributor.authorSharma, Gautamen_US
dc.contributor.authorNaik, Ajayen_US
dc.contributor.authorThachil, Ajiten_US
dc.contributor.authorChandra, Sharaden_US
dc.contributor.authorRajan, Vinayakrishnanen_US
dc.contributor.authorGerritse, Barten_US
dc.contributor.authorKaul, Upendraen_US
dc.contributor.authorSinha, Nakulen_US
dc.contributor.authorNarasimhan, C.en_US
dc.contributor.authorJain, R.K. Premchanden_US
dc.contributor.authorSaxena, Anilen_US
dc.date.accessioned2023-07-21T11:36:53Z
dc.date.available2023-07-21T11:36:53Z
dc.date.issued2022-06
dc.description.abstractAims: Sudden cardiac death (SCD) continues to be a devastating complication amongst survivors of myocardial infarction (MI). Mortality is high in the initial months after MI. The aims of the INSPIRE-ELR study were to assess the proportion of patients with significant arrhythmias early after MI and the association with mortality during 12 months of follow-up. Methods: The study included 249 patients within 14 days after MI with left ventricular ejection fraction (LVEF) _x0001_35% at discharge in 11 hospitals in India. Patients received a wearable external loop recorder (ELR) 5 ± 3 days after MI to monitor arrhythmias for 7 days. Results: Patients were predominantly male (86%) with a mean age of 56 ± 12 years. In 82%, reperfusion had been done and all received standard of care cardiovascular medications at discharge. LVEF was 32.2 ± 3.9%, measured 5.1 ± 3.0 days after MI. Of the 233 patients who completed monitoring (7.1 ± 1.5 days), 81 (35%) experienced significant arrhythmias, including Ventricular Tachycardia/Fibrillation (VT/ VF): 10 (4.3%); frequent Premature Ventricular Contractions (PVCs): 65 (28%); Atrial Fibrillation (AF): 8 (3.4%); chronic atrial flutter: 4 (1.7%); 2nd or 3rd degree Atrioventricular (AV) block: 4 (1.7%); and symptomatic bradycardia: 8 (3.4%). In total, 26 patients died. Mortality was higher in patients with clinically significant arrhythmia (at 12 months: 23.6% vs 4.8% with 19 vs 7 deaths, hazard ratio (HR) ¼ 5.5, 95% confidence interval (CI) 2.3 to 13.0, p < 0.0001). Excluding 7 deaths during ELR monitoring, HR ¼ 4.5, p < 0.001. Conclusion: ELR applied in patients with acute MI and LV dysfunction at the time of discharge identifies patients with high mortality risk.en_US
dc.identifier.affiliationsMax Super Speciality Hospital, New Delhi, Indiaen_US
dc.identifier.affiliationsKrishna Institute of Medical Sciences, Hyderabad, Indiaen_US
dc.identifier.affiliationsMadras Medical Mission, Chennai, Indiaen_US
dc.identifier.affiliationsSri Jayadeva Institute of Cardiovascular Science and Research, Bangalore, Indiaen_US
dc.identifier.affiliationsAll India Institute of Medical Sciences, Delhi, Indiaen_US
dc.identifier.affiliationsCare Institute of Medical Sciences, Ahmedabad, Indiaen_US
dc.identifier.affiliationsLisie Hospital, Cochin, Indiaen_US
dc.identifier.affiliationsKing George's Medical University, Lucknow, Indiaen_US
dc.identifier.affiliationsMedtronic India Pvt Ltd, Mumbai, Indiaen_US
dc.identifier.affiliationsMedtronic Bakken Research Center, Maastricht, the Netherlandsen_US
dc.identifier.affiliationsBatra Hospital and Medical Research Center, Delhi, Indiaen_US
dc.identifier.affiliationsSahara Hospital, Lucknow, Indiaen_US
dc.identifier.affiliationsAsian Institute of Gastroenterology, Hyderabad, Indiaen_US
dc.identifier.affiliationsEscorts Heart Institute and Research Center Ltd, Indiaen_US
dc.identifier.citationSingh Balbir, Rao Hygriv B., Pandurangi Ulhas, Manjunath C.N., Sharma Gautam, Naik Ajay, Thachil Ajit, Chandra Sharad, Rajan Vinayakrishnan, Gerritse Bart, Kaul Upendra, Sinha Nakul, Narasimhan C., Jain R.K. Premchand, Saxena Anil. Identifying high risk patients post myocardial infarction with reduced left ventricular function using loop recorders INSPIRE-ELR clinical study. Indian Heart Journal. 2022 Jun; 74(3): 194-200en_US
dc.identifier.issn0019-4832
dc.identifier.issn2213-3763
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/220894
dc.languageenen_US
dc.publisherCardiological Society of Indiaen_US
dc.relation.issuenumber3en_US
dc.relation.volume74en_US
dc.source.urihttps://doi.org/10.1016/j.ihj.2022.04.010en_US
dc.subjectMyocardial infarctionen_US
dc.subjectArrhythmiaen_US
dc.subjectExternal loop recorderen_US
dc.subjectMortalityen_US
dc.titleIdentifying high risk patients post myocardial infarction with reduced left ventricular function using loop recorders INSPIRE-ELR clinical studyen_US
dc.typeJournal Articleen_US
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