Characterisation of Cardiac Structure and Function in Patients with First Time Acute Coronary Syndromes in NZ: A MENZACS Substudy

Abstract

Aim: To investigate the changes in cardiac structure and function that occur in patients with first time acute coronary syndromes (ACS) in New Zealand. Method: 324 patients have been enrolled in the Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS) at Auckland City Hospital. Echocardiographic data for left ventricular (LV) size, LV ejection fraction (LVEF), and diastolic parameters were obtained from the electronic hospital database. Results: Mean age 61 years (range 30-100), 80 (25%) were women, 164 (51%) presented with STEMI and 141 (44%) with NSTEMI. Echocardiograms could be found in the clinical record for 265 (82%) of which 263 (99%) recorded some assessment of LVEF: 185 (70%) were a quantified EF, although only 51 (19%) had LVEF derived from LV volume assessment. For the patients with NSTEMI 76% had normal LVEF, 13% mild and 9% moderate LV impairment; proportions for those with STEMI were 51%, 30% and 23% respectively. Where LV volumes had been quantified, 19% patients had dilated LV when compared with sex-specific reference values. LV regional wall motion was described in 256 (97%), and abnormalities were present among 80% of the patients. Left atrial size and E/e’ were quantified in 233 (89%) of patients and were abnormal in 59 (25%) and 115 (49%) respectively. Conclusion: Among this cohort of patients with first time ACS semi-quantitative assessment of LV size and LVEF were commonly reported, significant abnormalities of LV function were present and these data provide important insights to inform the data required for the MENZACS Study.