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Updated: Jan 17, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Mortality After Non-ST-Segment Elevation Myocardial Infarction: Impact of Left Ventricular Function and Coronary
Nina Stødkilde-Jørgensen1, Kevin Kw Olesen2, Christine Gyldenkerne1
1Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Insights
In patients with non-ST-segment elevation myocardial infarction (NSTEMI), both reduced left ventricular ejection fraction (LVEF) and extensive coronary artery disease (CAD) significantly increase 5-year mortality risk. This combined risk is notably higher compared to the general population.
Area of Science:
- Cardiology
- Cardiovascular Research
- Clinical Outcomes
Background:
- Non-ST-segment elevation myocardial infarction (NSTEMI) is linked to coronary artery disease (CAD), potentially causing reduced left ventricular ejection fraction (LVEF) and increased mortality.
- The combined prognostic impact of LVEF and obstructive CAD on mortality in NSTEMI patients remains under-examined.
Purpose of the Study:
- To investigate the synergistic effect of LVEF and the extent of obstructive CAD on long-term mortality following an initial NSTEMI event.
Main Methods:
- Analysis of 8,770 patients with first-time NSTEMI and obstructive CAD from the Western Denmark Heart Registry (2010-2021).
- Patients stratified by LVEF categories (>50%, 41-50%, ≤40%) and coronary artery disease extent (1, 2, or 3 diseased vessels).
- Calculation of 5-year cumulative mortality incidence, hazard ratios (HRs), and comparison with a matched general population cohort.
Main Results:
- Five-year mortality increased progressively with decreasing LVEF and increasing CAD extent.
- The highest mortality risk was observed in patients with LVEF ≤40% and 3-vessel disease (3VD), with a 5-year mortality of 46% (adjusted HR 3.05).
- Patients with LVEF ≤40% and 3VD exhibited 24% higher absolute mortality compared to the general population.
Conclusions:
- In NSTEMI patients, the combination of impaired LVEF and extensive obstructive CAD significantly predicts increased 5-year mortality.
- These findings highlight the critical importance of assessing both LVEF and CAD burden for risk stratification in NSTEMI survivors.
Background:
Non-ST-segment elevation myocardial infarction (NSTEMI) due to coronary artery disease (CAD) can lead to reduced left ventricular ejection fraction (LVEF) and increased mortality. However, the interplay between LVEF and obstructive CAD on mortality has not been examined in patients with NSTEMI.
Objectives:
The purpose of this study was to examine the combined prognostic impact of LVEF and CAD on mortality following an NSTEMI.
Methods:
We included patients referred to coronary angiography due to first-time NSTEMI with obstructive CAD registered in the Western Denmark Heart Registry. Patients were grouped according to LVEF (>50%, 41% to 50%, and ≤40%) and the extent of obstructive CAD defined by vessel disease (VD) (1VD, 2VD, and 3VD). Five-year cumulative incidence proportions and HRs of mortality were calculated. Excess mortality was assessed by comparison with a sex- and age-matched general population cohort.
Results:
In total, 8,770 patients with NSTEMI and obstructive CAD were included between 2010 and 2021. The lowest 5-year mortality was observed for patients with LVEF >50% and 1VD (9%), followed by an increase with decreasing LVEF and increasing CAD. The highest mortality was observed for patients with LVEF ≤40% and 3VD (46%; adjusted HR 3.05; 95% CI: 2.51-3.70). This relationship was confirmed by comparison with the matched general population, where patients with LVEF ≤40% and 3VD had 24% higher absolute mortality.
Conclusions:
In patients with NSTEMI, the combined information on LVEF and the extent of obstructive CAD was associated with an increasing 5-year mortality. A comparison with a matched general population confirmed the findings.
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