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Insights into left ventricular systolic function recovery following acute coronary syndrome
Session:
SESSÃO DE POSTERS 08 - DOENÇAS CARDIOVASCULARES - PROGNÓSTICO NO SCA
Speaker:
Inês Rodrigues
Congress:
CPC 2025
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Cartazes
FP Number:
---
Authors:
Inês Arrobas Rodrigues; António Gonçalves; Marta Almeida; André Lobo; Inês Neves; Marta Leite; Leonor Moura; Fábio Nunes; Rafael Teixeira; Eduardo Vilela; Ricardo Fontes-Carvalho
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Background</strong></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Left ventricular (LV) dysfunction frequently occurs following acute coronary syndrome (ACS) and can significantly impact patient outcomes. Standard care aim to prevent and reverse adverse LV remodelling, but several factors may influence LV function recovery. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Aim</strong></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">This study aims to evaluate LV ejection fraction (LVEF) recovery at 12 months in patients with newly reduced LVEF following ACS and to identify predictors of LVEF non-recovery. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods</strong></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">All patients hospitalized for an ACS between April 2022 and December 2023 were retrospectively identified. Those with reduced LVEF (EF <50%) during the index event and no prior history of LV disfunction were included. LVEF was evaluated during the initial hospitalization and at 12 months. A multivariate logistic regression model was used to identify independent predictors of LVEF non-recovery at 12 months. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results</strong></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">A total of 339 patients with ACS were identified, of whom 135 (41%) patients had newly reduced LVEF and were included. The majority were male (75,6%) with a mean age of 64 years (SD 12,0) and a median LVEF of 41% (IQR 37-45). 65,2% of the patients presented with ST elevation myocardial infarction (STEMI) and 28,1% with non-STEMI; 6,7% were admitted for unstable angina. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">At 12 months, two-thirds of patients (66,7%) demonstrated LVEF recovery (LVEF ≥50%), while 16,3% had mildly reduced LVEF (40-49%) and 11,1% had LVEF <40%. Overall, the median LVEF significantly increased to 55% (IQR 46-59), p<0,001. Patients with persistent LVEF dysfunction (LVEF<50%) were more frequently diabetic compared with patients with LVEF recovery (43,2% vs 25,6%, p=0,059). No other significant differences were observed between groups. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">After adjusting for other cardiovascular risk factors, type of ACS at baseline, complete revascularization, adherence to treatment, and participation in cardiac rehabilitation programs, diabetes (OR 4,6, CI 95% 1,4 – 14,9, p=0,01) and previously known coronary artery disease (OR 2,3, CI 95% 1,0 – 5,0, p=0,04) were identified as independent predictors of LVEF non-recovery at one year.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion</strong></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">A significant proportion of patients developed newly reduced LVEF following an ACS. Current treatments enabled a favourable cardiac remodelling with LVEF recovery observed in two-thirds of patients at 12 months. Diabetes and previously known coronary artery disease were independent predictors of LVEF non-recovery at 12 months, possibly indicating low cardiac reserve in these patients.</span></span></p>
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