Key result
Reduced EF post-STEMI linked to ~15% greater absolute 8-year mortality versus preserved EF.
Why the study?
The prevalence and long-term prognostic impact of non-cardiac comorbidities in patients with reduced versus preserved EF after STEMI needed to be analyzed.
What is the prognostic impact of non-cardiac comorbidities and reduced versus preserved ejection fraction on 8-year mortality in STEMI patients undergoing pPCI?
Cohort (n=3,033)
What is the prognostic impact of non-cardiac comorbidities and reduced versus preserved ejection fraction on 8-year mortality in STEMI patients undergoing pPCI?
In STEMI patients undergoing pPCI, reduced ejection fraction and non-cardiac comorbidities (specifically CKD and diabetes) are significant independent predictors of long-term mortality.
Answers are grounded in this paper and cite their sources.
Reduced EF and CKD may warrant intensified post-STEMI surveillance; leaves open whether targeted interventions improve 8-year survival.
Background: We aimed to analyze the prevalence and long-term prognostic impact of non-cardiac comorbidities in patients with reduced and preserved left-ventricular ejection fraction (EF) following ST-elevation myocardial infarction (STEMI). Method: A total of 3033 STEMI patients undergoing primary percutaneous coronary intervention (pPCI) were divided in two groups: reduced EF < 50% and preserved EF ≥ 50%. The follow-up period was 8 years. Results: Preserved EF was present in 1726 (55.4%) patients and reduced EF was present in 1389 (44.5%) patients. Non-cardiac comorbidities were more frequent in patients with reduced EF compared with patients with preserved EF (38.9% vs. 27.4%, respectively, p < 0.001). Lethal outcome was registered in 240 (17.2%) patients with reduced EF and in 40 (2.3%) patients with preserved EF, p < 0.001. Diabetes and chronic kidney disease (CKD) were independent predictors for 8-year mortality in patients with preserved EF. In patients with reduced EF, CKD was independently associated with 8-year mortality. Conclusion: In patients who had reduced EF, the prevalence of non-cardiac comorbidities was higher than in patients who had preserved EF after STEMI. Only diabetes mellitus and CKD were independently associated with 8-year mortality in analyzed patients.
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Savić et al. (2023) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=3,033). Reduced EF < 50% vs. Preserved EF ≥ 50% was evaluated on 8-year mortality (p=< 0.001). Following STEMI, 8-year mortality was significantly higher in patients with reduced EF compared to preserved EF (17.2% vs. 2.3%, p<0.001), with CKD independently predicting mortality in both groups.
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