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ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 11 - 2024 |
doi: 10.3389/fcvm.2024.1458740
Two-year Clinical Outcome of Patients with Mildly Reduced Ejection Fraction After Acute Myocardial Infarction: Insights from the Prospective KAMIR-NIH Registry
Provisionally accepted- Wonju Severance Christian Hospital, Wŏnju, Republic of Korea
Background: Left ventricular ejection fraction (LVEF) is a crucial prognostic indicator of acute myocardial infarction (AMI). However, studies on the clinical characteristics and prognosis of patients with mildly reduced ejection fraction (EF) after AMI are lacking. Methods: We categorized 6,553 patients with AMI from the Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH) between November 2011 and December 2015 into three groups based on their EF, assessed by echocardiography during index hospitalization: reduced EF (LVEF ≤40%), mildly reduced EF (LVEF 41–49%), and preserved EF (LVEF ≥50%). The primary outcome was all-cause death within 2 years. The secondary outcomes included myocardial infarction (MI), revascularization, and patient-oriented composite endpoint (POCE) which was defined as composite of all-cause death, any MI, or revascularization. Results: Of the total 6,553 patients, 884 (13.5%) were classified into the reduced EF group, 1,749 (26.7%), into the mildly reduced EF group, and 3,920 (59.8%), into the preserved EF group. Patients with mildly reduced EF exhibited intermediate mortality (reduced EF, 24.7%; mildly reduced EF, 8.3%; preserved EF, 4.6%; p<0.0001), MI (3.9% vs. 2.7% vs. 2.6%; p<0.0046), and POCE (33.0% vs. 15.6% vs. 12.4%; p<0.0001) rates, albeit closer to those of the preserved EF. After adjustment for demographics, risk factors, admission status, and discharge medications, patients with mildly reduced EF showed a lower risk of all-cause death than those with reduced EF (mildly reduced EF group as a reference: HR, 1.74; 95% CI, 1.40–2.18; p<0.001), but it did not differ significantly from those with preserved EF (HR, 0.94; 95% CI, 0.75–1.18; p=0.999). Conclusions: Over a 2-year follow-up period, patients with AMI and mildly reduced EF demonstrated better prognoses than those with reduced EF, but did not differ significantly from those with preserved EF.
Keywords: acute myocardial infarction, Mildly reduced ejection fraction, prognosis, Prospective registry, Left ventricular ejecting fraction (LVEF)
Received: 03 Jul 2024; Accepted: 09 Sep 2024.
Copyright: © 2024 Jeon, Lee, Moon, KANG, Lee, Youn, Ahn, Ahn and Yoo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jun-Won Lee, Wonju Severance Christian Hospital, Wŏnju, Republic of Korea
Jin Sil Moon, Wonju Severance Christian Hospital, Wŏnju, Republic of Korea
Jung-Hee Lee, Wonju Severance Christian Hospital, Wŏnju, Republic of Korea
Min-Soo Ahn, Wonju Severance Christian Hospital, Wŏnju, Republic of Korea
Sung Gyun Ahn, Wonju Severance Christian Hospital, Wŏnju, Republic of Korea
Byung-Su Yoo, Wonju Severance Christian Hospital, Wŏnju, Republic of Korea
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