# Symptom burden and secondary prevention in patients with left ventricular systolic dysfunction after acute myocardial infarction: a nationwide register-based study in Sweden

## TL;DR

This study shows that patients with severe heart function issues after a heart attack in Sweden face more symptoms and lower adherence to recovery measures compared to those with normal heart function.

## Contribution

The study provides contemporary nationwide data on symptom burden and secondary prevention in patients with left ventricular systolic dysfunction after a heart attack.

## Key findings

- Patients with reduced ejection fraction had higher rates of shortness of breath and readmission.
- Those with severe dysfunction were less likely to participate in education and physical therapy programs.
- No significant differences were found in chest pain or quality of life between groups.

## Abstract

There is a lack of contemporary data describing patients with left ventricular (LV) systolic dysfunction post myocardial infarction (MI) in terms of symptom burden and secondary prevention measures. The aim of this study was to describe patients with various degrees of LV systolic dysfunction after a first MI, their symptom burden, quality of life and adherence to recommended secondary prevention measures in a nationwide patient material.

Patients (n=49 564) registered in the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease registry between 2011 and 2018, diagnosed with a first acute MI, discharged alive and with no previous heart failure, were stratified by degree of LV systolic dysfunction.

Compared with patients with normal ejection fraction (EF≥50%), patients with a reduced EF (<30%) more often experienced shortness of breath (32.3% vs 5.6%, adjusted OR (95% CI): 7.45 (6.22 to 8.92)), had more often been readmitted (48.1% vs 31.2%, 1.87 (1.61 to 2.19)) and were more often on sick leave (26.6% vs 9.5%, 3.35 (2.45 to 4.58)), whereas there were no significant differences regarding chest pain and quality of life at the follow-up visit after 11–13 months. Patients with EF <30% had participated in education programme (44.9% vs 55.5%, 0.70 (0.60 to 0.81)) and physical therapy (11.3% vs 14.9%, 0.68 (0.58 to 0.79)) and have been physically active at least 30 min per day for at least 5 days per week (35.5% vs 40.2%, 0.86 (0.73 to 1.01)) to a lesser extent.

Contemporary representative data show that LV systolic dysfunction after MI is associated with a very high symptom burden and worse secondary prevention after 11–13 months.