Savic, Lidija (16507811000)Lidija (16507811000)SavicMrdovic, Igor (10140828000)Igor (10140828000)MrdovicPerunicic, Jovan (9738988200)Jovan (9738988200)PerunicicAsanin, Milika (8603366900)Milika (8603366900)AsaninLasica, Ratko (14631892300)Ratko (14631892300)LasicaMarinkovic, Jelena (7004611210)Jelena (7004611210)MarinkovicVasiljevic, Zorana (6602641182)Zorana (6602641182)VasiljevicOstojic, Miodrag (34572650500)Miodrag (34572650500)Ostojic2025-06-122025-06-122012https://doi.org/10.1111/j.1540-8183.2011.00698.xhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-84859704489&doi=10.1111%2fj.1540-8183.2011.00698.x&partnerID=40&md5=476b01870383d4f335710a6f893c5f4fhttps://remedy.med.bg.ac.rs/handle/123456789/9658Background: The aim of this study was to assess the impact of combined left ventricular systolic dysfunction (LVSD) and renal dysfunction (RD) on 1-year overall mortality and major adverse cardiovascular events (MACEs) (comprising cardiovascular death, nonfatal renfarction, target vessel revascularization, and nonfatal stroke) in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention (pPCI). Methods: One thousand three hundred ninety eight patients with first myocardial infarction, undergoing pPCI were divided into four groups according to the presence of LVSD (ejection fraction [EF] <40%) and/or baseline RD (estimated glomerular filtration rate <60 mL/min per m 2): Group I (no LVSD and no RD); Group II (LVSD, no RD); Group III (RD, no LVSD); Group IV (LVSD + RD). Results: One-year mortality rates in Groups I, II, III, and IV were 2.6%, 15.2%, 10.6%, and 34.2% and 1-year MACE rates were 5.7%, 19.5%, 17.1% and 35.7%, respectively. Patients in Groups II, III, and IV had an increased probability of 1-year overall mortality and MACE as compared to Group I. Overall mortality: Group II HR 2.1 (95% CI 1.1-4.2); Group III HR 2.1 (95% CI 1.1-4.1); Group IV HR 4.8 (95% CI 2.4-9.4); MACE: Group II HR 2.2 (95% CI 1.1-4.2); Group III HR 2.2 (95% CI 1.1-4.3); Group IV HR 5.1 (95% CI 2.6-10.1). The LVSD-RD combination was the strongest independent predictor for 1-year outcomes. Conclusions: The LVSD-RD combination is associated with an approximately five-fold increase in 1-year overall mortality and MACE after pPCI. The evaluation of the renal function in patients with LVSD represents a simple method which enables a more precise stratification of the risks related to the occurrence of adverse events in long-term patient follow-up. © 2011, Wiley Periodicals, Inc.