DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20215035
Published: 2021-12-28

Reduced left ventricular ejection fraction in patients with acute coronary syndrome as a risk factor for mortality

Parvaiz Kadloor, Mohammed Hidayathullah, Abhishek Golla

Abstract


Background: The study aimed to evaluate left ventricular ejection fraction (LVEF) as the risk factor for mortality in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).

Methods: This was an observational, single centre study. The patients who were admitted at tertiary care centre in India during the period February 2014 to June 2015 who were diagnosed with ACS were included in the study. The patients were evaluated by dividing into two groups based on LVEF. The patients were followed up to 1 year.

Results: Total 100 patients were included in the study. Chest pain was the most prevalent complaint (60%). Seventy patients presented with STEMI (ST-segment elevation myocardial infarction) and 30 with NSTEMI (non-ST-segment elevation myocardial infarction). Seventy five patients had ejection fraction ≥40% and 25 patients had reduced ejection fraction. Reduced LVEF did not show any statistical difference in patients with presentation as STEMI and NSTEMI or need for revascularisation. At year follow up, total 9 patients died. However, reduced LVEF led to statistically higher deaths (p<0.05%).

Conclusions: In our study it was observed that patients with ACS complicated by heart failure with reduced ejection fraction have a markedly increased short- and long-term mortality rates compared to ACS patients without heart failure.


Keywords


Acute coronary syndrome, Left ventricular ejection fraction, Percutaneous coronary intervention

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References


Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, et al. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2017;390(10100):1151-210.

Kumar A, Cannon CP. Acute coronary syndromes: diagnosis and management, part I. Mayo Clinic Proceedings. Elsevier; 2009.

Brezinov OP, Klempfner R, Zekry SB, Goldenberg I, Kuperstein R. Prognostic value of ejection fraction in patients admitted with acute coronary syndrome: a real world study. Medicine. 2017;96(9).

Mukherjee JT, Beshansky JR, Ruthazer R, Alkofide H, Ray M, Kent D, et al. In-hospital measurement of left ventricular ejection fraction and one-year outcomes in acute coronary syndromes: results from the IMMEDIATE Trial. Cardiovascular Ultrasound. 2015;14(1):1-8.

Ye Z, Lu H, Li L. Reduced left ventricular ejection fraction is a risk factor for in-hospital mortality in patients after percutaneous coronary intervention: A hospital-based survey. Bio Med Res Int. 2018;2018.

Daugaard G, Lassen U, Bie P, Pedersen EB, Jensen KT, Abildgaard U, et al. Natriuretic peptides in the monitoring of anthracycline induced reduction in left ventricular ejection fraction. Eur J Heart Failure. 2005;7(1):87-93.

Yip GWK, Zhang Q, Xie JM, Liang YJ, Liu YM, Yan B, et al. Resting global and regional left ventricular contractility in patients with heart failure and normal ejection fraction: insights from speckle-tracking echocardiography. Heart. 2011;97(4):287-94.

Prasad A, Hastings JL, Shibata S, Popovic ZB, Arbab-Zadeh A, Bhella PS, et al. Characterization of static and dynamic left ventricular diastolic function in patients with heart failure with a preserved ejection fraction. Circulation Heart Failure. 2010;3(5):617-26.

Mamas MA, Anderson SG, O'Kane PD, Keavney B, Nolan J, Oldroyd KG, et al. Impact of left ventricular function in relation to procedural outcomes following percutaneous coronary intervention: insights from the British Cardiovascular Intervention Society. Eur Heart J. 2014;35(43):3004-12.

Chopra H. STEMI care in India and the real world: role of thrombolysis.

Libby P. Current concepts of the pathogenesis of the acute coronary syndromes. Circulation. 2001;104(3):365-72.

Kim SH, Kim HJ, Han S, Yoo BS, Choi DJ, Kim JJ, et al. The limited prognostic role of echocardiograms in short-term follow-up after acute decompensated heart failure: An analysis of the Korean Heart Failure (KorHF) Registry. PloS One. 2017;12(12):0188938.

Farmakis D, Simitsis P, Bistola V, Triposkiadis F, Ikonomidis I, Katsanos S, et al. Acute heart failure with mid-range left ventricular ejection fraction: clinical profile, in-hospital management, and short-term outcome. Clinic Res Cardiol. 2017;106(5):359.

Altaie S, Khalife W. The prognosis of mid‐range ejection fraction heart failure: a systematic review and meta‐analysis. ESC Heart Failure. 2018;5(6):1008-16.

Cameli M, Pastore MC, DeCarli G, Henein MY, Mandoli GE, Lisi E, et al. Acute HF score, a multiparametric prognostic tool for acute heart failure: a real-life study. Int J Cardiol. 2019;296:103-8.

Lombardi C, Peveri G, Cani D, Latta F, Bonelli A, Tomasoni D, et al. In‐hospital and long‐term mortality for acute heart failure: analysis at the time of admission to the emergency department. ESC Heart Failure. 2020;7(5):2650-61.

Alidoosti M, Salarifar M, Zeinali A, Kassaian S, Dehkordi M, Fatollahi M. Short-and long-term outcomes of percutaneous coronary intervention in patients with low, intermediate and high ejection fraction: cardiovascular topics. Cardiovascul J Africa. 2008;19(1):17-21.

Sardi GL, Gaglia MA, Maluenda G, Torguson R, Laynez-Carnicero A, Ben-Dor I, et al. Outcome of percutaneous coronary intervention utilizing drug-eluting stents in patients with reduced left ventricular ejection fraction. Am J Cardiol. 2012;109(3):344-51.

Vakili H, Sadeghi R, Rezapoor P, Gachkar L. In-hospital outcomes after primary percutaneous coronary intervention according to left ventricular ejection fraction. ARYA Atherosclerosis. 2014;10(4):211.