Combined Impact of Heart Function and Blocked Arteries Predicts NSTEMI Outcomes
Aarhus, Denmark – New research confirms that the combination of reduced heart pumping efficiency and the severity of coronary artery disease dramatically worsens the prognosis for patients experiencing a non-ST-elevation myocardial infarction (NSTEMI), a common type of heart attack. The study, published in JACC: Advances, provides the first detailed analysis of how thes two independent risk factors interact to influence mortality following an NSTEMI.This finding has immediate implications for risk stratification and treatment decisions in a patient population representing a important clinical challenge.
NSTEMI patients are a diverse group, routinely assessed with echocardiograms to measure left ventricular ejection fraction (LVEF) – a key indicator of heart function – and coronary angiography to determine the extent of coronary artery disease (CHD). Both LVEF and CHD are known to independently increase the risk of death, but until now, the combined effect remained unclear.Danish researchers, led by Nina Stødkilde-Jørgensen from Aarhus University Hospital, have now quantified this synergistic risk, offering a more precise understanding of long-term outcomes.
the prospective cohort study analyzed data from 8,770 adults with obstructive CAD who experienced a first-time NSTEMI between 2010 and 2021, as recorded in the Western Denmark Heart Registry.Patients undergoing coronary angiography were included, but those with prior myocardial infarction, percutaneous coronary intervention, bypass surgery, or non-obstructive CAD were excluded from the analysis.
Researchers categorized patients based on LVEF (greater than 50%, 41-50%, and 40% or less) and the extent of CHD (one-, two-, or three-vessel disease). Five-year all-cause mortality was the primary endpoint, and findings were compared to a matched control group from the general population with no history of myocardial infarction. The study’s findings reveal a clear correlation between declining LVEF and increasing vessel disease with a heightened risk of mortality.
