Aims Left ventricular ejection fraction (LVEF) recovery after an ST-segment elevation myocardial infarction (STEMI) identifies a group of patients with a better prognosis. However, the association between long-term outcomes and LVEF recovery among patients with STEMI undergoing primary percutaneous coronary intervention (PCI) has not yet been well investigated. Our study aims to detect differences in long-term all-cause and cardiovascular mortality between patients who recover LVEF at 1-year post-PCI and those who do not, and search for predictors of LVEF recovery. Methods and results This is a retrospective, single-centre study of 2170 consecutive patients admitted for STEMI in which primary PCI is performed. LVEF was determined at admission and at 1-year follow-up. The primary outcomes were long-term all-cause and cardiovascular mortality. Among the 2168 patients with baseline LVEF data, 822 (38%) had a LVEF < 50% and 1346 (62%) ≥ 50%. Among those with LVEF < 50%, LVEF data at 1-year were available in 554, and 299 (54.0%) presented with complete recovery (LVEF ≥ 50%). LVEF recovery was associated with a reduction in long-term all-cause and cardiovascular mortality (P < 0.0001). Female sex, treatment with ACEIs, lower creatinine levels, infarct-related artery different from the left main or left anterior descendent artery, and absence of prior ischaemic heart disease were independently associated with LVEF recovery. Conclusions Nearly 40% of patients with STEMI undergoing primary PCI presented with LVEF depression at hospital admission. Among them, LVEF recovery at 1-year occurred in more than 50% and was independently associated with a significant decrease in long-term all-cause and cardiovascular mortality.

中文翻译：

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左心室射血分数恢复对 ST 段抬高型心肌梗死患者接受初次经皮冠状动脉介入治疗的预后影响：一项 11 年所有患者登记的分析

目的 ST 段抬高型心肌梗死 (STEMI) 后左心室射血分数 (LVEF) 的恢复确定了一组预后较好的患者。然而，在接受直接经皮冠状动脉介入治疗 (PCI) 的 STEMI 患者中，长期结果与 LVEF 恢复之间的关系尚未得到很好的研究。我们的研究旨在检测 PCI 后 1 年 LVEF 恢复的患者与未恢复的患者之间长期全因死亡率和心血管死亡率的差异，并寻找 LVEF 恢复的预测因子。方法和结果 这是一项回顾性、单中心研究，纳入了 2170 名接受直接 PCI 的 STEMI 患者。LVEF 在入院时和 1 年随访时确定。主要结局是长期全因死亡率和心血管死亡率。在有基线 LVEF 数据的 2168 名患者中，822 名 (38%) 的 LVEF ＜50% 和 1346 (62%) ≥ 50%。在 LVEF < 的人群中 50%，554 人获得 1 年 LVEF 数据，299 人（54.0%）呈现完全恢复（LVEF ≥ 50%）。LVEF 恢复与长期全因死亡率和心血管死亡率的降低相关（P < 0.0001）。女性、ACEI 治疗、较低的肌酐水平、与左主干或左前降支不同的梗死相关动脉以及既往无缺血性心脏病与 LVEF 恢复独立相关。结论 近 40% 的接受直接 PCI 的 STEMI 患者在入院时出现 LVEF 抑制。他们之中，