J Cardiovasc Interv.
2025 Jan;4(1):40-55. 10.54912/jci.2024.0015.
Three-Year Outcomes Based on Left Ventricular Ejection Fraction in Patients With Non-ST-Segment Elevation Myocardial Infarction Undergoing Newer-Generation Drug-Eluting Stent Implantation
- Affiliations
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- 1Division of Cardiology, Department of Internal Medicine, Kangwon National University College of Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
- 2Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
- 3Department of Biomedical Laboratory Science, Honam University, Gwangju, Korea
- 4Cardiology Division, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
- 5Department of Cardiology, Changwon Hanmaeum Hospital, Hanyang University College of Medicine, Changwon, Korea
- 6Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
- 7Cardiology Department, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
- 8Cardiovascular Center, Gwangju Veterans Hospital, Chonnam National University Hospital, Gwangju, Korea
- KMID: 2564254
- DOI: http://doi.org/10.54912/jci.2024.0015
Abstract
- Background
Owing to insufficient available relevant research, we compared 3-year outcomes among non-ST-segment elevation myocardial infarction (NSTEMI) patients who underwent successful percutaneous coronary intervention with newer-generation drug-eluting stents, categorized into heart failure (HF) with reduced ejection fraction (EF) (≤ 40%, group A), HF with mildly reduced EF (41–49%, group B), and HF with preserved EF (≥ 50%, group C).
Methods
Total 4,558 patients with NSTEMI were included from the Korea Acute Myocardial Infarction Registry-National Institutes of Health dataset, and divided into 3 groups (group A, n = 549; group B, n = 805; and group C, n = 3,204). The primary outcomes were the occurrence of major adverse cardiac and cerebrovascular events (MACCE), defined as all-cause death, recurrent myocardial infarction (MI), repeat coronary revascularization, and stroke. Secondary outcomes were the individual components of MACCE and rate of rehospitalization for HF.
Results
The in-hospital all-cause and cardiac death (CD) rates in group A were significantly higher than those in groups B and C. The 3-year adjusted MACCE, all-cause death, CD, all-cause death or MI, and hospitalization for HF rates in group A were significantly higher than those in groups B (P < 0.001 for all comparisons) and C (P < 0.001 for all comparisons), and the rates in group B were higher than those in group C (P = 0.006, P < 0.001, P < 0.001, P < 0.001, and P = 0.007, respectively). The recurrent MI rate was higher in group A than in groups B (P = 0.026) and C (P = 0.016).
Conclusions
Mortality was the highest in group A, lowest in group C, and intermediate in group B. Therefore, for patients in groups A and B, thorough monitoring and strict guidelinedirected medical treatment should be considered to reduce mortality rates.
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