Prognostic impact of left ventricular ejection fraction recovery in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention : analysis of an 11-year all-comers registry
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissionsoup.com..
AIMS: Left ventricular ejection fraction (LVEF) recovery after an ST-segment elevation myocardial infarction (STEMI) identifies a group of patients with a better prognosis. However, the association between long-term outcomes and LVEF recovery among patients with STEMI undergoing primary percutaneous coronary intervention (PCI) has not yet been well investigated. Our study aims to detect differences in long-term all-cause and cardiovascular mortality between patients who recover LVEF at 1-year post-PCI and those who do not, and search for predictors of LVEF recovery.
METHODS AND RESULTS: This is a retrospective, single-centre study of 2170 consecutive patients admitted for STEMI in which primary PCI is performed. LVEF was determined at admission and at 1-year follow-up. The primary outcomes were long-term all-cause and cardiovascular mortality. Among the 2168 patients with baseline LVEF data, 822 (38%) had a LVEF < 50% and 1346 (62%) ≥ 50%. Among those with LVEF < 50%, LVEF data at 1-year were available in 554, and 299 (54.0%) presented with complete recovery (LVEF ≥ 50%). LVEF recovery was associated with a reduction in long-term all-cause and cardiovascular mortality (P < 0.0001). Female sex, treatment with ACEIs, lower creatinine levels, infarct-related artery different from the left main or left anterior descendent artery, and absence of prior ischaemic heart disease were independently associated with LVEF recovery.
CONCLUSIONS: Nearly 40% of patients with STEMI undergoing primary PCI presented with LVEF depression at hospital admission. Among them, LVEF recovery at 1-year occurred in more than 50% and was independently associated with a significant decrease in long-term all-cause and cardiovascular mortality.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
European heart journal. Acute cardiovascular care - 10(2021), 8 vom: 27. Okt., Seite 898-908 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Otero-García, Oscar [VerfasserIn] |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 24.11.2021 Date Revised 24.11.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/ehjacc/zuab058 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM328721344 |
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| 100 | 1 | |a Otero-García, Oscar |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prognostic impact of left ventricular ejection fraction recovery in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention |b analysis of an 11-year all-comers registry |
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| 520 | |a Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a AIMS: Left ventricular ejection fraction (LVEF) recovery after an ST-segment elevation myocardial infarction (STEMI) identifies a group of patients with a better prognosis. However, the association between long-term outcomes and LVEF recovery among patients with STEMI undergoing primary percutaneous coronary intervention (PCI) has not yet been well investigated. Our study aims to detect differences in long-term all-cause and cardiovascular mortality between patients who recover LVEF at 1-year post-PCI and those who do not, and search for predictors of LVEF recovery | ||
| 520 | |a METHODS AND RESULTS: This is a retrospective, single-centre study of 2170 consecutive patients admitted for STEMI in which primary PCI is performed. LVEF was determined at admission and at 1-year follow-up. The primary outcomes were long-term all-cause and cardiovascular mortality. Among the 2168 patients with baseline LVEF data, 822 (38%) had a LVEF < 50% and 1346 (62%) ≥ 50%. Among those with LVEF < 50%, LVEF data at 1-year were available in 554, and 299 (54.0%) presented with complete recovery (LVEF ≥ 50%). LVEF recovery was associated with a reduction in long-term all-cause and cardiovascular mortality (P < 0.0001). Female sex, treatment with ACEIs, lower creatinine levels, infarct-related artery different from the left main or left anterior descendent artery, and absence of prior ischaemic heart disease were independently associated with LVEF recovery | ||
| 520 | |a CONCLUSIONS: Nearly 40% of patients with STEMI undergoing primary PCI presented with LVEF depression at hospital admission. Among them, LVEF recovery at 1-year occurred in more than 50% and was independently associated with a significant decrease in long-term all-cause and cardiovascular mortality | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Left ventricular ejection fraction recovery | |
| 650 | 4 | |a Primary percutaneous coronary intervention | |
| 650 | 4 | |a Prognosis | |
| 650 | 4 | |a ST-segment elevation myocardial infarction | |
| 700 | 1 | |a Cid-Álvarez, Ana Belén |e verfasserin |4 aut | |
| 700 | 1 | |a Juskova, Mària |e verfasserin |4 aut | |
| 700 | 1 | |a Álvarez-Álvarez, Belén |e verfasserin |4 aut | |
| 700 | 1 | |a Tasende-Rey, Pablo |e verfasserin |4 aut | |
| 700 | 1 | |a Gude-Sampedro, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a García-Acuña, José María |e verfasserin |4 aut | |
| 700 | 1 | |a Agra-Bermejo, Rosa |e verfasserin |4 aut | |
| 700 | 1 | |a López-Otero, Diego |e verfasserin |4 aut | |
| 700 | 1 | |a Sanmartín-Pena, Juan Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Martínez-Monzonís, Amparo |e verfasserin |4 aut | |
| 700 | 1 | |a Trillo-Nouche, Ramiro |e verfasserin |4 aut | |
| 700 | 1 | |a González-Juanatey, José R |e verfasserin |4 aut | |
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