Does left ventricular ejection fraction category impact 3-year outcomes in patients with NSTEMI undergoing PCI with newer-generation drug-eluting stents?
In NSTEMI patients undergoing PCI, an LVEF ≤40% is associated with significantly higher 3-year rates of MACCE and heart failure hospitalization compared to those with LVEF >40%.
Background: Owing to insufficient available relevant research, we compared 3-year outcomes among non-ST-segment elevation myocardial infarction (NSTEMI) patients who underwent successful percutaneous coronary intervention with newer-generation drug-eluting stents, categorized into heart failure (HF) with reduced ejection fraction (EF) ( 40%, group A), HF with mildly reduced EF (41-49%, group B), and HF with preserved EF ( 50%, group C).Methods: Total 4,558 patients with NSTEMI were included from the Korea Acute Myocardial Infarction Registry-National Institutes of Health dataset, and divided into 3 groups (group A, n = 549; group B, n = 805; and group C, n = 3,204).The primary outcomes were the occurrence of major adverse cardiac and cerebrovascular events (MACCE), defined as all-cause death, recurrent myocardial infarction (MI), repeat coronary revascularization, and stroke.Secondary outcomes were the individual components of MACCE and rate of rehospitalization for HF. Results:The in-hospital all-cause and cardiac death (CD) rates in group A were significantly higher than those in groups B and C. The 3-year adjusted MACCE, all-cause death, CD, all-cause death or MI, and hospitalization for HF rates in group A were significantly higher than those in groups B (P < 0.001 for all comparisons) and C (P < 0.001 for all comparisons),
Kim et al. (Wed,) studied this question.