Karabağ Yavuz, Çınar Tufan, Çağdaş Metin, Rencüzoğulları İbrahim, Tanık Veysel Ozan
a Department of Cardiology, Kafkas University , Kars , Turkey.
b Department of Cardiology, Health Sciences University, Sultan Abdülhamid Han Training and Research Hospital , Istanbul , Turkey.
Acta Cardiol. 2019 Aug;74(4):351-358. doi: 10.1080/00015385.2018.1501140. Epub 2018 Aug 23.
The recent reclassification of heart failure (HF) patients in the 2016 European Society of Cardiology HF guidelines according to the left ventricular ejection fraction (LVEF) has created a 'grey area' consisting of midrange ejection fraction (mrEF) HF patients with LVEFs of 40-49%. Additionally, there is limited data regarding the in-hospital and long-term prognoses of patients with an mrEF after an ST-elevation myocardial infarction (STEMI). Therefore, we aimed to evaluate the baseline characteristics, in-hospital and long-term mortalities, clinical events in mrEF, preserved ejection fraction (pEF), and reduced ejection fraction (rEF) patients during their hospital stays in a cohort of consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI). One thousand two hundred sixty patients were enrolled in the study. The incidences of all the clinical events were recorded during the hospital stays and the mean follow-up duration was 34.4 ± 15.4 months. The incidence of HF signs and symptoms was statistically significant in the mrEF patients when compared to the pEF patients during their hospital stays (3vs. 0.8%, p = 0.05). The overall survival rate in the mrEF patients was between those of the rEF and pEF patients. However, the rate of rehospitalisation due to HF was significantly higher in the mrEF patients when compared to the pEF patients [ (log-rank) < 0.001]. Although the mrEF patients with primary PCI-treated STEMIs exhibited similar baseline clinical characteristics, their in-hospital, long term mortality rates and rate of rehospitalisation due to HF were different from those of the rEF and mrEF patients.
2016年欧洲心脏病学会心力衰竭（HF）指南根据左心室射血分数（LVEF）对HF患者进行了重新分类，这产生了一个“灰色区域”，即LVEF为40%-49%的射血分数中间范围（mrEF）HF患者。此外，关于ST段抬高型心肌梗死（STEMI）后mrEF患者的住院和长期预后的数据有限。因此，我们旨在评估连续接受直接经皮冠状动脉介入治疗（PCI）的STEMI患者队列中，mrEF、射血分数保留（pEF）和射血分数降低（rEF）患者在住院期间的基线特征、住院和长期死亡率、临床事件。1260名患者纳入该研究。记录住院期间所有临床事件的发生率，平均随访时间为34.4±15.4个月。与pEF患者相比，mrEF患者在住院期间出现HF体征和症状的发生率具有统计学意义（3%对0.8%，p=0.05）。mrEF患者的总体生存率介于rEF和pEF患者之间。然而，与pEF患者相比，mrEF患者因HF再次住院的发生率显著更高[（对数秩）<0.001]。尽管接受直接PCI治疗的STEMI的mrEF患者表现出相似的基线临床特征，但他们的住院、长期死亡率以及因HF再次住院的发生率与rEF和mrEF患者不同。
