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Left Ventricular Ejection Fraction Trajectory and Long-Term Outcomes Following Percutaneous Coronary Intervention for Myocardial Infarction

Sampath-Kumar, Revathy ; von Koch, Sacharias LU orcid ; Mohammad, Moman A. LU orcid ; Fenerty, Anna ; Reeves, Ryan R. ; Al Khiami, Belal ; Ang, Lawrence ; Melendez, Anna ; Mahmud, Ehtisham and Erlinge, David LU orcid , et al. (2026) In JACC: Advances 5(7).
Abstract

Background: Data are lacking on left ventricular ejection fraction (LVEF) trajectory following myocardial infarction (MI). Objectives: This study aimed to evaluate the impact of LVEF trajectory after percutaneous coronary intervention (PCI) for MI on long-term outcomes. Methods: Patients undergoing PCI for MI (2007-2022) with serial echocardiograms were identified in the Swedish Coronary Angiography and Angioplasty Registry and the UC San Diego internal National Cardiovascular Data Registry CathPCI Registry. All-cause mortality and heart failure hospitalization within 6 years were assessed with time-to-event analysis adjusted for baseline characteristics. Results: Of 13,439 patients (mean age 64 ± 10 years, 24.5% female, 46.8%... (More)

Background: Data are lacking on left ventricular ejection fraction (LVEF) trajectory following myocardial infarction (MI). Objectives: This study aimed to evaluate the impact of LVEF trajectory after percutaneous coronary intervention (PCI) for MI on long-term outcomes. Methods: Patients undergoing PCI for MI (2007-2022) with serial echocardiograms were identified in the Swedish Coronary Angiography and Angioplasty Registry and the UC San Diego internal National Cardiovascular Data Registry CathPCI Registry. All-cause mortality and heart failure hospitalization within 6 years were assessed with time-to-event analysis adjusted for baseline characteristics. Results: Of 13,439 patients (mean age 64 ± 10 years, 24.5% female, 46.8% ST-segment elevation MI), 28.2% had consistently reduced LVEF (redEF), 14.8% recovered their LVEF (recEF), 53.0% had consistently preserved LVEF (pEF), and 3.9% decreased from preserved to reduced LVEF (decEF). Heart failure hospitalization rates were 40.0% for redEF, 30.4% for decEF, 16.1% for recEF, and 6.4% for pEF (P < 0.001). Compared to pEF, the heart failure hospitalization risk was significantly higher for redEF (adjusted HR [aHR]: 8.49; 95% CI: 7.49-9.64; P < 0.001), decEF (aHR: 5.74; 95% CI: 4.69-7.02; P < 0.001), and recEF (aHR: 3.18; 95% CI: 2.70-3.76; P < 0.001). Mortality rates were 14.0% for redEF, 14.9% for decEF, 7.8% for recEF, and 6.7% for pEF (P < 0.001). Compared to pEF, the mortality risk was significantly higher for redEF (aHR: 2.20; 95% CI: 1.86-2.59; P < 0.001), decEF (aHR: 2.10; 95% CI: 1.56-2.82; P < 0.001), and recEF (aHR: 1.30; 95% CI: 1.02-1.65; P = 0.032). Conclusions: LVEF trajectory after MI significantly impacts long-term outcomes. Even patients with LVEF recovery remain at increased risk for heart failure hospitalization and mortality compared to those with pEF.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
heart failure hospitalization, left ventricular ejection fraction, myocardial infarction, percutaneous coronary intervention
in
JACC: Advances
volume
5
issue
7
article number
102881
publisher
American College of Cardiology
external identifiers
  • pmid:42314580
  • scopus:105042132785
ISSN
2772-963X
DOI
10.1016/j.jacadv.2026.102881
language
English
LU publication?
yes
id
6d4d45d1-bb47-48cb-bb5f-6d7493f3651e
date added to LUP
2026-07-03 14:54:02
date last changed
2026-07-04 03:25:25
@article{6d4d45d1-bb47-48cb-bb5f-6d7493f3651e,
  abstract     = {{<p>Background: Data are lacking on left ventricular ejection fraction (LVEF) trajectory following myocardial infarction (MI). Objectives: This study aimed to evaluate the impact of LVEF trajectory after percutaneous coronary intervention (PCI) for MI on long-term outcomes. Methods: Patients undergoing PCI for MI (2007-2022) with serial echocardiograms were identified in the Swedish Coronary Angiography and Angioplasty Registry and the UC San Diego internal National Cardiovascular Data Registry CathPCI Registry. All-cause mortality and heart failure hospitalization within 6 years were assessed with time-to-event analysis adjusted for baseline characteristics. Results: Of 13,439 patients (mean age 64 ± 10 years, 24.5% female, 46.8% ST-segment elevation MI), 28.2% had consistently reduced LVEF (redEF), 14.8% recovered their LVEF (recEF), 53.0% had consistently preserved LVEF (pEF), and 3.9% decreased from preserved to reduced LVEF (decEF). Heart failure hospitalization rates were 40.0% for redEF, 30.4% for decEF, 16.1% for recEF, and 6.4% for pEF (P &lt; 0.001). Compared to pEF, the heart failure hospitalization risk was significantly higher for redEF (adjusted HR [aHR]: 8.49; 95% CI: 7.49-9.64; P &lt; 0.001), decEF (aHR: 5.74; 95% CI: 4.69-7.02; P &lt; 0.001), and recEF (aHR: 3.18; 95% CI: 2.70-3.76; P &lt; 0.001). Mortality rates were 14.0% for redEF, 14.9% for decEF, 7.8% for recEF, and 6.7% for pEF (P &lt; 0.001). Compared to pEF, the mortality risk was significantly higher for redEF (aHR: 2.20; 95% CI: 1.86-2.59; P &lt; 0.001), decEF (aHR: 2.10; 95% CI: 1.56-2.82; P &lt; 0.001), and recEF (aHR: 1.30; 95% CI: 1.02-1.65; P = 0.032). Conclusions: LVEF trajectory after MI significantly impacts long-term outcomes. Even patients with LVEF recovery remain at increased risk for heart failure hospitalization and mortality compared to those with pEF.</p>}},
  author       = {{Sampath-Kumar, Revathy and von Koch, Sacharias and Mohammad, Moman A. and Fenerty, Anna and Reeves, Ryan R. and Al Khiami, Belal and Ang, Lawrence and Melendez, Anna and Mahmud, Ehtisham and Erlinge, David and Ben-Yehuda, Ori}},
  issn         = {{2772-963X}},
  keywords     = {{heart failure hospitalization; left ventricular ejection fraction; myocardial infarction; percutaneous coronary intervention}},
  language     = {{eng}},
  number       = {{7}},
  publisher    = {{American College of Cardiology}},
  series       = {{JACC: Advances}},
  title        = {{Left Ventricular Ejection Fraction Trajectory and Long-Term Outcomes Following Percutaneous Coronary Intervention for Myocardial Infarction}},
  url          = {{http://dx.doi.org/10.1016/j.jacadv.2026.102881}},
  doi          = {{10.1016/j.jacadv.2026.102881}},
  volume       = {{5}},
  year         = {{2026}},
}