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

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 (less than or equal to 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 less than or equal to 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. (C) 2004 Elsevier Inc. All rights reserved.