ST段抬高型心肌梗死合并左心室射血分数保留的心力衰竭患者的长期预后

Long-Term Prognosis in Patients with ST-Elevation Myocardial Infarction Complicated by Heart Failure with Preserved Left Ventricular Ejection Fraction.

作者信息

Savic Lidija, Simic Damjan, Lasica Ratko, Krljanac Gordana, Matic Dragan, Asanin Milika, Stankovic Sanja, Antonijevic Nebojsa, Mrdovic Igor

机构信息

Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.

Cardiology Intensive Care Unit & Cardiology Clinic, Emergency Hospital, University Clinical Center of Serbia, 11000 Belgrade, Serbia.

出版信息

J Cardiovasc Dev Dis. 2025 Jul 16;12(7):272. doi: 10.3390/jcdd12070272.

DOI:10.3390/jcdd12070272

PMID:40710797

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12295454/

Abstract

BACKGROUND/AIM: We aimed to analyze eight-year mortality in patients with ST-elevation myocardial infarction (STEMI) complicated by the development of in-hospital heart failure with preserved ejection fraction (HFpEF).

METHOD

We analyzed 3260 STEMI patients treated with primary PCI (pPCI). Reduced EF was defined as value <50% and preserved EF as value ≥50%. Patients were divided in three groups: without HF, with HFpEF, and with HF with reduced EF (HFrEF). Patients with cardiogenic shock at admission were excluded.

RESULTS

In-hospital HF was registered in 759 (23.2%) patients. Among the patients with in-hospital HF, 80 (10.5%) patients had HFpEF. Patients with HFpEF had significantly higher 8-year mortality compared with patients without HF (11.2% vs. 3.5%, respectively, < 0.001), but significantly lower mortality compared with patients with HFrEF: 11.2% vs. 25.1%, respectively, < 0.001. In the Cox regression model, HFpEF and HFrEF were independent predictors for 8-year mortality-HFpEF: HR1.85 (95%CI 1.26-4.25); HFrEF: 4.89 (95%CI 3.19-6.42).

CONCLUSION

Development of in-hospital HFpEF in STEMI patients was an independent predictor for long-term mortality. The negative prognostic impact of HFpEF was weaker when compared to the impact of in-hospital HFrEF.

摘要

背景/目的：我们旨在分析合并院内射血分数保留的心力衰竭（HFpEF）的ST段抬高型心肌梗死（STEMI）患者的八年死亡率。

方法

我们分析了3260例接受直接经皮冠状动脉介入治疗（pPCI）的STEMI患者。射血分数降低定义为值<50%，射血分数保留定义为值≥50%。患者分为三组：无心力衰竭、HFpEF和射血分数降低的心力衰竭（HFrEF）。排除入院时发生心源性休克的患者。

结果

759例（23.2%）患者出现院内心力衰竭。在院内发生心力衰竭的患者中，80例（10.5%）患有HFpEF。与无心力衰竭的患者相比，HFpEF患者的八年死亡率显著更高（分别为11.2%和3.5%，<0.001），但与HFrEF患者相比死亡率显著更低：分别为11.2%和25.1%，<0.001。在Cox回归模型中，HFpEF和HFrEF是八年死亡率的独立预测因素-HFpEF：HR1.85（95%CI 1.26-4.25）；HFrEF：4.89（95%CI 3.19-6.42）。