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 304 patients who had undergone ppci between 2009 and 2011. the association between lvef and in-hospital outcomes of patients was assessed. results: lvef ≤ 25%, 25% < lvef < 50%, and lvef ≥ 50% were presented in 23 (7.6%), 150 (49.3%), and 128 (42.1%) of the patients, respectively. three patients (0.01%) died before echocardiography. there was no significant difference among aforementioned three groups regarding baseline characteristics, except age (p = 0.012) and sex (p = 0.016). cumulative number of cardiogenic shock and death were 7 (2.3%) and 22 (7.2%), respectively; with significant differences between three lvef groups. age more than 70 years old, pulmonary edema, systolic blood pressure < 100 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 < 0.050). conclusion: this study not only demonstrates that lvef ≤ 50% is associated with a higher incidence of in-hospital adverse events, but also identifies characteristics that are strongly correlated with the risk of lvef ≤ 50% and death after ppci.