Their take? Only ejection fraction seems worthy for risk stratification so far.
Here's what they said about ejection fraction:
The LVEF has been recognized as a predictor of all-cause mortality in patients with coronary artery disease (CAD) for >30 years. One early study by the Multicenter Postinfarction Research Group showed in 866 post–myocardial infarction (MI) patients that the strongest predictor of 1-year cardiac mortality was the LVEF. This finding has withstood the test of time. In the VALIANT (trial), a randomized comparison of captopril, valsartan, and their combination in post-MI patients (n = 14 609) with left ventricular dysfunction, CHF, or both, LVEF was a strong predictor of SCD or cardiac arrest. The risk of SCD or cardiac arrest increased by 21% for every 5% decrease in LVEF.Participants at the meeting were as follows:
Left ventricular ejection fraction is also a strong predictor of all-cause mortality in patients with nonischemic cardiomyopathy. The MACAS (trial) was a prospective cohort study of 343 patients with nonischemic cardiomyopathy and an LVEF ≤45% who were followed for a mean of 52 months. Left ventricular ejection fraction was the only significant predictor of major arrhythmic events with a relative risk (RR) of 2.3 per 10% decrease in LVEF (95% CI 1.5-3.3, P < .0001) in patients with sinus rhythm and 4.5 per 10% decrease in LVEF (95% CI 1.5-13.2, P = .0008) in patients with atrial fibrillation.
Participants from the Academia: Sana M Al-Khatib, MD, MHS (co-Director), J Thomas Bigger, MD, Alfred Buxton, MD, Robert M Califf, MD, Anne Curtis, MD, Jeptha Curtis, MD, Bernard J. Gersh, MB, ChB, DPhil, Michael R. Gold, MD, PhD, Jeff Goldberger, MD, Stephen C. Hammill, MD, Jeff Healey, MD, MS, Mark Hlatky, MD, Stefan Hohnloser, MD, Raymond J Kim, MD, Kerry Lee, PhD, Daniel Mark, MD, MPH, L. Brent Mitchell, MD, Eric Prystowsky, MD, Gillian Sanders, PhD (co-Director), and Wojciech Zareba, MD, PhDThe conference was funded by AstraZeneca, Bayer, Boston Scientific, Cambridge Heart Inc, Medtronic, Reliant Pharmaceuticals, St Jude Medical.
Participants from the Centers for Medicare and Medicaid Services: Steve Phurrough, MD, MPA
Participants from the US Food and Drug Administration: Norman Stockbridge, MD, PhD, Robert Temple, MD, Bram Zuckerman, MD
Participant from the National Institutes of Health: Robin Boineau, MD, Michael Domanski, MD
Participant from Agency for Healthcare Research and Quality: Elise Berliner, PhD
Participant from the Heart Rhythm Society staff: Joel Harder
Participants from Industry: Mark Carlson, MD, Eric Fain, MD, Ali Haghighi-Mood, PhD, Steve Ketchum, PhD, Steve McQuillan MS, Marcus Mianulli MA, Philip Sager, MD, Dan Schaber, PharmD, Robert Shalwitz, MD, Joseph Smith, MD, PhD, Michael A Stein, MD, David Steinhaus, MD
Coordinating Staff: Marelle Molbert and Cass Finley from the Duke Clinical Research Institute.