Long-Term Risk of Cardiovascular Death in Patients With Mildly Reduced Ejection Fraction After Acute Myocardial...

Area of Science:

• Cardiology
• Cardiovascular Medicine
• Clinical Research

Background:

• Prognostic implications of mildly reduced ejection fraction (mrEF) post-acute myocardial infarction (AMI) are unclear.
• Long-term cardiovascular death risk in AMI patients with mrEF requires further investigation.

Purpose of the Study:

• To investigate the long-term risk of cardiovascular death in patients with mrEF following AMI.
• To identify predictors of cardiovascular death in this patient group.

Main Methods:

• Analysis of 18,668 patients from 2 prospective, multicenter registries.
• Stratification of patients into reduced EF (≤40%), mildly reduced EF (41%-49%), and preserved EF (≥50%) groups.
• Development of a clinical prediction score for cardiovascular death in the mrEF cohort.

Main Results:

• Cardiovascular death rates were 22.3% (reduced EF), 10.3% (mrEF), and 7.3% (preserved EF) over 37.9 months.
• Independent predictors for cardiovascular death in mrEF patients included age >65, hypertension, stroke, severe renal insufficiency, and Killip class ≥3.
• A prediction score with >2 predictors identified high-risk mrEF patients (AUC=0.746), with risks comparable to the reduced EF group.

Conclusions:

• Patients with mrEF post-AMI have a moderate risk of cardiovascular death.
• Clinical predictors can effectively identify a high-risk mrEF subpopulation with significantly elevated cardiovascular death risk.