A prospective study found impaired left ventricular function predicted job retirement after acute myocardial infarction

J Clin Epidemiol. 2004 Aug;57(8):837-42. doi: 10.1016/j.jclinepi.2003.12.022.

Abstract

Objective: Impaired left ventricular function is associated with poor prognosis after acute myocardial infarction (MI). It might be hypothesized that impaired left ventricular function would also affect work outcome; however, no existing data address this hypothesis. This study examines whether reduced left ventricular systolic function had any influence on the 4-year retirement rate after acute MI.

Study design and setting: We conducted a prospective study including 242 working-active patients with MI. Left ventricular ejection fraction (LVEF) was estimated by echocardiography during hospital admission. Data about work outcome after 4 years were collected by telephone interviews.

Results: Fifty percent were retired by the end of follow-up. Moderately or severely reduced LVEF (35%) increased the risk of retirement almost twofold (risk ratio RR=1.8, 95% confidence interval CI=1.3-2.5). After adjusting for confounding factors, reduced LVEF was an independent predictor of retirement. Based on a stratified analysis, being female (RR=3.90, 95% CI=1.18-12.62) or having heavy physical job demands (RR=3.83, 95% CI=1.02-14.30) had a more pronounced impact on retirement for patients with LVEF 35%, compared with patients with better left ventricular function.

Conclusion: We conclude that impaired left ventricular systolic function is a prognostic determinant of retirement from the job market after acute MI.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Denmark / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications*
  • Myocardial Infarction / mortality
  • Physical Exertion
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Recurrence
  • Retirement / statistics & numerical data*
  • Ultrasonography
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / etiology*
  • Ventricular Dysfunction, Left / rehabilitation*