Coronary disease & ACSCohort study
Incidence and Predictors of Heart Failure with Reduced and Preserved Ejection Fraction After ST-Elevation Myocardial Infarction in the Contemporary Era of Early Percutaneous Coronary Intervention
- Cohort study
- all-comer ST-elevation myocardial infarction (STEMI) patients
- CardioLines Biobank
Authors' conclusion
In the current era of early STEMI reperfusion, still one in 10 patients develops heart failure, with approximately half of the patients with a reduced and half with a mildly reduced or normal LVEF. Predictors for the development of HFrEF were different from HFpEF.
Study context
- Population
- All-comer STEMI patients in the era of early PCI (CardioLines Biobank)
- Participants
- 1,172 patients
- Outcome
- Incidence of post-STEMI HF, stratified by LVEF
- Follow-up
- Median 3.7 years (2.0, 5.5)
Main finding
As reported in the abstract
Total incidence of post-STEMI HF
10.9%
Heart failure with reduced ejection fraction (HFrEF) (share of HF)
52.1%
HF with mildly reduced EF (share of HF)
29.4%
Heart failure with preserved ejection fraction (HFpEF) (share of HF)
18.5%
Observational data: associations, not effects.
Further findings
Independent baseline predictors of HFrEF
- Male sex
- β = 0.97, p = 0.009
- Lung crepitations
- β = 1.09, p = 0.001
- Potassium level (mmol/L)
- β = 0.43, p = 0.012
- Neutrophil count (109/L)
- β = 0.09, p = 0.001
- Reduced left ventricular ejection fraction (LVEF)
- β = 1.91, p < 0.001
Independent baseline predictors of HFpEF
- Female sex
- β = 0.99, p = 0.029
- Pre-existing kidney failure
- β = 1.95, p = 0.003
- Greater left atrial volume index
- β = 0.04, p = 0.033
LV function on follow-up echocardiography · median follow-up 20 months
- Improvement in LVEF
- P < 0.001
- Diastolic function parameters showed both improvement and deterioration
Original publication
Summarised from the published abstract; every number is checked against it