Key result
Reduced EF linked to ~15% greater absolute 8-year mortality versus preserved EF after STEMI PCI.
Why the study?
The prognostic impact of non-cardiac comorbidities can vary depending on left ventricular ejection fraction in patients with STEMI.
Does the prognostic impact of non-cardiac comorbidities on long-term mortality differ between STEMI patients with reduced versus preserved ejection fraction?
Cohort (n=3,115)
Does the prognostic impact of non-cardiac comorbidities on long-term mortality differ between STEMI patients with reduced versus preserved ejection fraction?
Following STEMI, chronic kidney disease independently predicts 8-year mortality regardless of ejection fraction, whereas diabetes is an independent predictor only in patients with preserved ejection fraction.
Mortality risk stratification by EF after STEMI may benefit from comorbidity assessment; leaves open differential prognostic roles in reduced versus preserved EF.
Background: The prognostic impact of non-cardiac comorbidities can vary in relation to the left ventricular ejection fraction (EF) in patients with ST-elevation myocardial infarction (STEMI). The aim was to analyze prevalence and long-term prognostic impact of non-cardiac co-morbidities in patients with reduced and preserved EF following STEMI. Method: 3115 STEMI patients undergoing primary PCI were divided in two groups: reduced EF <50% and preserved EF≥50%. 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 as 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 CKD were independent predictors for 8-year mortality in patients with preserved EF while in patients with reduced EF only CKD was independently associated with 8-year mortality. Conclusion: In the present study the prevalence of non-cardiac comorbidities is similar in patients with reduced and preserved EF after STEMI, but only DM and CKD are independently associated with long-term mortality.
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Savić et al. (2023) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=3,115). Reduced ejection fraction (<50%) vs. Preserved ejection fraction (≥50%) was evaluated on 8-year mortality (p=<0.001). In STEMI patients undergoing primary PCI, 8-year mortality was significantly higher in those with reduced EF compared to preserved EF (17.2% vs 2.3%, p<0.001).
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