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

Background/aim: to analyze eight year mortality in patients with ST-elevation myocardial infarction (STEMI) complicated by the development of 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 HFwith 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 as compared with patients without HF (11.2% vs 3.5%, respectively, p< 0.001), but significantly lower mortality as compared with patients with HFrEF: 11.2% vs 25.1%, respectively, p< 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.