In-hospital outcomes after primary percutaneous coronary intervention according to left ventricular ejection fraction

BACKGROUND: The primary objective of primary percutaneous coronary intervention (pPCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) is not only to restore the blood flow in the infarct-related artery, but also to save the patients’ quality and duration of their life. Since left ventricular ejection fraction (LVEF) is a known predictor of clinical outcomes in STEMI patients, the possible association between characteristics of a large group of patients who undergo pPCI with LVEF and death was evaluated. METHODS: This prospective cohort study included ۳۰۴ patients who had undergone pPCI between ۲۰۰۹ and ۲۰۱۱. The association between LVEF and in-hospital outcomes of patients was assessed. RESULTS: LVEF ≤ ۲۵%, ۲۵% < LVEF < ۵۰%, and LVEF ≥ ۵۰% were presented in ۲۳ (۷.۶%), ۱۵۰ (۴۹.۳%), and ۱۲۸ (۴۲.۱%) of the patients, respectively. Three patients (۰.۰۱%) died before echocardiography. There was no significant difference among aforementioned three groups regarding baseline characteristics, except age (P = ۰.۰۱۲) and sex (P = ۰.۰۱۶). Cumulative number of cardiogenic shock and death were ۷ (۲.۳%) and ۲۲ (۷.۲%), respectively; with significant differences between three LVEF groups. Age more than ۷۰ years old, pulmonary edema, systolic blood pressure <۱۰۰ mm Hg, shock, post-PCI thrombolysis in myocardial infarction (MI) flow grade, corrected thrombolysis in MI frame count, angiographic success and ST-segment resolution showed significant association with death (P < ۰.۰۵۰). CONCLUSION: This study not only demonstrates that LVEF ≤ ۵۰% is associated with a higher incidence of in-hospital adverse events, but also identifies characteristics that are strongly correlated with the risk of LVEF ≤ ۵۰% and death after pPCI.   Keywords: Myocardial Infarction, Percutaneous Coronary Intervention, Ejection Fraction, Corrected Trombolysis in Myocardial Infarction