Prognostic Implications of Mid-Range Left Ventricular Ejection Fraction on Patients Presenting With ST- Segment Elevation Myocardial Infarction

Abstract The new European Society of Cardiology guidelines reclassified heart failure according to left ventricular ejection fraction (LVEF), recognizing patients with mid-range EF [(mrEF), 40-49%)] as a distinct group. We sought to investigate the clinical profile, in-hospital outcomes and long term mortality of ST elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI) who had mrEF. We conducted a retrospective study of 2086 consecutive STEMI patients between December 2007 and June 2016 who underwent primary PCI and had a comprehensive echocardiographic examination performed within 72 h of hospital admission. Patients were stratified according to their LVEF – mrEF (40-49%), reduced EF [(rEF), 50%] groups and evaluated for baseline characteristics, in-hospital outcomes, as well as for long term mortality. A total of 858/2086 (41%) patients had mrEF, 215/2086 (10%) had rEF and 1013/2086 (48%) had pEF. Patients with mrEF had nearly similar baseline co-morbidities and similar 30-day mortality compared to patients with pEF (2% vs.1%, p=0.17). In a univariate analysis, long term mortality was higher compared with those with pEF (9.8%vs. 7.2%, p