In-hospital and long-term prognoses of patients with a mid-range ejection fraction after an ST-segment myocardial

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Yavuz Karabağ1, Tufan Çınar2, Metin Çağdaş1

  • 1a Department of Cardiology, Kafkas University , Kars , Turkey.

Acta Cardiologica
|August 24, 2018
PubMed

Insights

Patients with midrange ejection fraction (mrEF) heart failure (HF) after ST-elevation myocardial infarction (STEMI) show higher rehospitalization rates. Their outcomes are distinct from reduced ejection fraction (rEF) and preserved ejection fraction (pEF) groups.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Heart Failure Research

Background:

  • The 2016 ESC guidelines introduced a midrange ejection fraction (mrEF) category (40-49% LVEF) for heart failure (HF).
  • Limited data exists on the prognosis of mrEF patients post-ST-elevation myocardial infarction (STEMI).
  • This study addresses the gap in understanding in-hospital and long-term outcomes for mrEF patients after primary PCI for STEMI.

Purpose of the Study:

  • To evaluate baseline characteristics, in-hospital, and long-term mortality.
  • To compare clinical events in mrEF, preserved ejection fraction (pEF), and reduced ejection fraction (rEF) patients post-STEMI.
  • To assess the prognostic implications of the mrEF category in STEMI patients undergoing primary percutaneous coronary intervention (PCI).

Main Methods:

  • A cohort of 1260 consecutive STEMI patients undergoing primary PCI was analyzed.
  • Patients were categorized into mrEF, pEF, and rEF groups based on LVEF.
  • Clinical events, in-hospital outcomes, and long-term mortality (mean follow-up 34.4 months) were recorded.

Main Results:

  • HF signs and symptoms were more frequent in mrEF patients compared to pEF patients (3% vs. 0.8%, p=0.05).
  • Overall survival rates for mrEF patients fell between rEF and pEF groups.
  • Rehospitalization due to HF was significantly higher in mrEF patients than in pEF patients (p < 0.001).

Conclusions:

  • STEMI patients with mrEF treated with primary PCI show distinct clinical outcomes.
  • While baseline characteristics may be similar, mrEF patients experience different in-hospital and long-term mortality rates.
  • The rate of rehospitalization due to HF is notably higher in the mrEF group compared to pEF patients.

Keywords:
Heart failureST-segment elevation myocardial infarctionin-hospital prognosislong-term prognosismid-range ejection fractionprimary percutaneous coronary intervention

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