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05.06.2021 | Original Paper

Left ventricular function recovery after ST-elevation myocardial infarction: correlates and outcomes

verfasst von: Jeroen Dauw, Pieter Martens, Sébastien Deferm, Philippe Bertrand, Petra Nijst, Lowie Hermans, Mats Van den Bergh, Isabel Housen, Amin Hijjit, Maarten Warnants, Daan Cottens, Bert Ferdinande, Mathias Vrolix, Jo Dens, Koen Ameloot, Matthias Dupont, Wilfried Mullens

Erschienen in: Clinical Research in Cardiology | Ausgabe 9/2021

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Abstract

Background

Contemporary data on left ventricular function (LVF) recovery in patients with left ventricular dysfunction after ST-elevation myocardial infarction (STEMI) are scarce and to date, no comparison has been made with patients with a baseline normal LVF. This study examined predictors of LVF recovery and its relation to outcomes in STEMI.

Methods

Patients presenting with STEMI between January 2010 and December 2016 were categorized in three groups after 3 months according to left ventricular ejection fraction (EF): (i) baseline normal LVF (EF ≥ 50% at baseline); (ii) recovered LVF (EF < 50% at baseline and ≥ 50% after 3 months); and (iii) reduced LVF (EF < 50% at baseline and after 3 months). Heart failure hospitalization, all-cause mortality and cardiovascular mortality were compared between the three groups.

Results

Of 577 patients, 341 (59%) patients had a baseline normal LVF, 112 (19%) had a recovered LVF and 124 (22%) had a reduced LVF. Independent correlates of LVF recovery were higher baseline EF, lower peak troponin and cardiac arrest. After median 5.8 years, there was no difference in outcomes between patients with LVF recovery and baseline normal LVF. In contrast, even after multivariate adjustment, patients with persistently reduced LVF had a higher risk for heart failure hospitalization (HR 5.00; 95% CI 2.17–11.46) and all-cause mortality (HR 1.87; 95% CI 1.11–3.16).

Conclusion

In contemporary treated STEMI patients, prognosis is significantly worse in those with a persistently reduced LVF after 3 months, compared with patients with a baseline normal LVF and those with LVF recovery.

Graphic abstract

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Titel: Left ventricular function recovery after ST-elevation myocardial infarction: correlates and outcomes
verfasst von: Jeroen Dauw
Pieter Martens
Sébastien Deferm
Philippe Bertrand
Petra Nijst
Lowie Hermans
Mats Van den Bergh
Isabel Housen
Amin Hijjit
Maarten Warnants
Daan Cottens
Bert Ferdinande
Mathias Vrolix
Jo Dens
Koen Ameloot
Matthias Dupont
Wilfried Mullens
Publikationsdatum: 05.06.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 9/2021
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-021-01887-y

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Left ventricular function recovery after ST-elevation myocardial infarction: correlates and outcomes