A-68 | Impact of Long-Term LVEF Trajectories on Outcomes after Primary PCI for Anterior STEMI

Reduced left ventricular ejection fraction (LVEF) after STEMI is associated with poor prognosis, but the impact of long-term LVEF trajectories on outcomes has not been studied. The UC San Diego Health National Cardiovascular Data Registry (NCDR) CathPCI Registry was used to obtain data on patients that underwent primary PCI for anterior STEMI from January 2007 to September 2022 with serial transthoracic echocardiogram (TTE) ≥ 3 months after STEMI. All-cause mortality within 10 years post PCI was assessed. N=210 patients were included, mean age was 60 ± 13, 79% male. Median TTE follow-up was 931 days (IQR 379-2127). At time of STEMI, N=144 (69%) had reduced LVEF ≤ 50% and N=66 (31%) had preserved LVEF > 50%. At TTE follow up N=51 (24%) recovered their LVEF, N=93 (44%) had consistently reduced LVEF, N=54 (25.7%) had consistently preserved LVEF, and N=12 (6%) decreased from preserved to reduced LVEF. There was no difference in GDMT prescription at discharge between groups. Patients with reduced LVEF at follow up were more likely to have HTN, HLD, diabetes, and prior PCI. Patients with decreased LVEF or consistently reduced LVEF had higher all-cause mortality at 10 years compared to patients with recovered LVEF or consistently preserved LVEF (33.3% and 31.2% vs 7.8% and 5.6% P<0.001). Patients with decreased LVEF or consistently reduced LVEF after primary PCI for anterior STEMI had higher all-cause mortality at 10 years.