Backgrounds: Reduced left ventricular ejection fraction (LVEF) after acute myocardial infarction (AMI), which implies\nthe occurrence of cardiac dysfunction, impacts cardiac prognosis, even after primary percutaneous coronary\nintervention (PCI). This study was designed to clarify the difference of clinical and angiographic predictors for\nreduced LVEF in ST-elevation myocardial infarction (STEMI) patients with left anterior descending artery (LAD) or\nnon-LAD vessel as culprit artery.\nMethods: This was a retrospective study to review a total of 553 patients of STEMI underwent primary PCI in our\nhospital. All patients underwent echocardiography. Univariate analysis, multivariate analysis and classification and\nregression tree (CART) were performed between LAD related AMI and non-LAD related STEMI. The primary\noutcome was the occurrence of reduced LVEF 4ââ?¬â??6 days after PCI.\nResults: In this study, culprit arteries of STEMI were 315 in LAD system (6 in left main artery, 309 in LAD) and 238 in\nnon-LAD system (63 in left circumflex and 175 in right coronary artery). Compared with non-LAD group, post-MI\nLVEF was significantly reduced in LAD related STEMI group (52.4 Ã?± 9.3 % vs. 57.1 Ã?± 7.8 %, P < 0.01). Multivariate\nanalysis indicated that elder (>65 years), time to hospital and proximal occlusion were associated with reduced\nLVEF (<55 %) in LAD related STEMI patients. However, in non-LAD patients, time to hospital, multivessel stenosis\nand post-PCI blood pressure predicted the occurrence of reduced LVEF. Furthermore, CART analysis also obtained\nsimilar findings.\nConclusions: Patients with LAD or non-LAD related STEMI could suffer reduced LVEF, while the clinical and\nangiographic predictors for the occurrence were different.
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