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

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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Funding

Jeroen Dauw, Sébastien Deferm and Wilfried Mullens are researchers for the Limburg Clinical Research Center (LCRC) UHasselt-ZOL-Jessa, supported by the foundation Limburg Sterk Merk (LSM), province of Limburg, Flemish government, Hasselt University, Ziekenhuis Oost-Limburg and Jessa Hospital.

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Authors

Contributions

JeD: conceptualization, methodology, formal analysis, investigation, data curation, writing–original draft, visualization. PM: conceptualization, methodology, writing–review and editing. SD: conceptualization, methodology, writing–review and editing. PB: writing–review and editing. PN: writing–review and editing. LH: investigation, data curation. MVdB: investigation, data curation. IH: investigation, data curation. AH: investigation, data curation. MW: investigation, data curation. DC: writing–review and editing. BF: writing–review and editing. MV: writing–review and editing. JoD: writing–review and editing. KA: writing–review and editing. MD: writing–review and editing. WM: conceptualization, methodology, supervision, writing–review and editing.

Corresponding author

Correspondence to Jeroen Dauw.

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Conflict of interest

All authors report no relationships that could be construed as a conflict of interest.

Ethics approval

The study was approved by the Institutional Review Board (18/00107R).

Consent to participate

Consent was waived by the Institutional Review Board.

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Cite this article

Dauw, J., Martens, P., Deferm, S. et al. Left ventricular function recovery after ST-elevation myocardial infarction: correlates and outcomes. Clin Res Cardiol 110, 1504–1515 (2021). https://doi.org/10.1007/s00392-021-01887-y

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Keywords

  • ST-elevation myocardial infarction
  • Left ventricular systolic dysfunction
  • Ejection fraction recovery
  • Heart failure hospitalization
  • Mortality