Key result
Supranormal LVEF linked to ~23% lower 3-year mortality versus normal LVEF after acute MI.
Why the study?
Real-world evidence on clinical outcomes of patients with acute myocardial infarction and supranormal left ventricular ejection fraction is lacking.
Does supranormal LVEF (≥65%) improve 3-year all-cause mortality in patients with acute myocardial infarction compared to normal LVEF?
Cohort (n=27,903)
Yes
Does supranormal LVEF (≥65%) improve 3-year all-cause mortality in patients with acute myocardial infarction compared to normal LVEF?
In patients with acute myocardial infarction, supranormal LVEF (≥65%) is associated with significantly lower 3-year all-cause mortality compared to normal LVEF.
Does not support targeting supranormal LVEF post-MI; leaves open causality versus confounding in observational data.
Background/aims: Despite cumulative evidence of superior outcomes for acute myocardial infarction (AMI) with normal left ventricular ejection fraction (LVEF) compared to those for AMI with reduced LVEF, real-world evidence on outcomes of patients with AMI and supranormal LVEF (snLVEF) is lacking. Therefore, this study aimed to evaluate the clinical outcomes of patients with AMI and snLVEF. Methods: A total of 27,903 patients with AMI were included from the Korean nationwide AMI cohort between November 2011 and June 2020 after excluding those with unmeasurable LVEF. Patients were classified into four groups according to LVEF: supranormal (≥65%), normal (50%-64%), mid-range (40%-49%), and reduced (<40%). The primary outcome was 3-year all-cause mortality. Results: Across four hierarchical Cox models, snLVEF was consistently associated with lower 3-year all-cause mortality compared with normal LVEF (a crude model HR 0.71; 95% CI 0.58-0.87; a fully-adjusted model HR 0.77; 95% CI 0.60-0.98), with similar estimates observed in intermediate models. Conclusions: Patients with AMI and snLVEF experienced the best clinical outcomes with the lowest mortality across the four groups.
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Oh et al. (2026) conducted a cohort in Acute myocardial infarction (n=27,903). Supranormal left ventricular ejection fraction (≥65%) vs. Normal left ventricular ejection fraction (50%-64%) was evaluated on 3-year all-cause mortality (HR 0.77, 95% CI 0.60-0.98). Supranormal left ventricular ejection fraction (≥65%) was associated with a lower risk of 3-year all-cause mortality compared to normal ejection fraction in patients with acute myocardial infarction (HR 0.77).
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