Related Experiment Video

Updated: Jun 4, 2026

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
14:35

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs

Published on: April 17, 2021

Complete revascularization and heart failure risk in acute coronary syndrome across the ejection fraction spectrum:

Xiaozhi Luo1,2, Jiaan Nong3, Shaowei Xu1,2

  • 1Department of Cardiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China.

Frontiers in Cardiovascular Medicine
|June 3, 2026
PubMed

Insights

Complete revascularization (CR) significantly reduces heart failure hospitalizations or cardiovascular death in acute coronary syndrome patients with LVEF 40-50%. This benefit is specific to non-ST-segment elevation ACS, emphasizing LVEF-dependent efficacy.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Research

Background:

  • Acute coronary syndrome (ACS) patients with reduced left ventricular ejection fraction (LVEF) face significant risks of heart failure (HF) hospitalization and cardiovascular death.
  • Optimal revascularization strategies in ACS patients with preserved LVEF (≥40%) remain under investigation.

Purpose of the Study:

  • To compare the impact of complete revascularization (CR) versus incomplete revascularization (ICR) on major adverse cardiovascular events in ACS patients with LVEF ≥40%.

Main Methods:

  • Retrospective analysis of 1,834 ACS patients with multivessel disease and LVEF ≥40%.
  • CR defined as percutaneous coronary intervention (PCI) of all suitable non-culprit lesions.
  • Primary endpoint: first hospitalization for HF or cardiovascular death.

Main Results:

  • CR was associated with a lower risk of the primary endpoint in patients with LVEF <50% (HR 0.46; 95% CI 0.22-0.96).
  • This benefit was observed in non-ST-segment elevation ACS (NSTE-ACS) but not in ST-segment elevation myocardial infarction (STEMI).
  • CR group: 4.6% vs. ICR group: 7.8% reached the primary endpoint (p < 0.001).

Conclusions:

  • Complete revascularization significantly reduces HF hospitalization or cardiovascular death in ACS patients with LVEF 40%-50%.
  • The efficacy of CR appears dependent on LVEF, with benefits diminishing as LVEF increases.
  • Observational nature necessitates cautious interpretation due to potential residual confounding.
Abstract

Keywords:
acute coronary syndromecomplete revascularizationheart failureleft ventricular ejection fractionmultivessel disease

Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...