Left Ventricular Ejection Fraction Trajectory and Long-Term Outcomes Following Percutaneous Coronary Intervention for
Revathy Sampath-Kumar1, Sacharias von Koch2, Moman A Mohammad2
1UCSD Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, La Jolla, California, USA.
JACC. Advances
|June 18, 2026
Summary
Left ventricular ejection fraction (LVEF) trajectory after myocardial infarction (MI) significantly impacts long-term outcomes. Even with LVEF recovery, patients face higher risks of heart failure hospitalization and mortality compared to those with preserved LVEF.
Area of Science:
- Cardiology
- Clinical Outcomes
- Echocardiography
Background:
- Limited data exist on left ventricular ejection fraction (LVEF) changes after myocardial infarction (MI).
- Understanding LVEF trajectory is crucial for predicting long-term prognosis post-MI.
Purpose of the Study:
- To assess the impact of LVEF trajectory following percutaneous coronary intervention (PCI) for MI on long-term outcomes.
- To analyze the association between different LVEF patterns and subsequent heart failure hospitalization and mortality.
Main Methods:
- Retrospective analysis of 13,439 patients undergoing PCI for MI between 2007-2022.
- Utilized serial echocardiograms from Swedish and UC San Diego registries.
- Assessed all-cause mortality and heart failure hospitalization within 6 years using time-to-event analysis.
Main Results:
- Four LVEF trajectories were identified: consistently reduced (redEF), recovered (recEF), consistently preserved (pEF), and decreased (decEF).
- Heart failure hospitalization rates were highest in redEF (40.0%) and decEF (30.4%), and mortality rates were highest in redEF (14.0%) and decEF (14.9%).
- Compared to pEF, redEF, decEF, and recEF groups showed significantly higher risks for both heart failure hospitalization and mortality.
Conclusions:
- LVEF trajectory after MI is a significant determinant of long-term patient outcomes.
- Even patients achieving LVEF recovery (recEF) experience increased risks for heart failure hospitalization and mortality.
- These findings highlight the importance of monitoring LVEF post-MI and considering trajectory in risk stratification.
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