Recently, the supra-normal left ventricular ejection fraction (snLVEF) has been proposed, based on extensive datasets indicating increased all-cause mortality in individuals with an LVEF exceeding 65%. However, the implications of an LVEF > 65% in the context of acute coronary syndrome (ACS) remain underexplored.

The aim of the present study was to investigate the correlation between supra-normal left ventricular ejection fraction (snLVEF) and major adverse cardiovascular events (MACE) in patients with ACS.

Methods: A total of 874 ACS patients (560 men, mean age 59.5 ± 10.0; 314 women, mean age 61.5 ± 8.9) who underwent their first coronary angiography during the period from March 2013 to October 2015 were divided into 2 groups: normal LVEF (nLVEF) (55% ≤ EF ≤ 65%) and snLVEF (EF > 65%), according to their echocardiography results. The patients were evaluated for MACE after surgery by collecting clinical data and long-term follow-up data. This correlation was further analyzed by Kaplan-Meier analysis and Cox regression analysis.

The follow-up data revealed a significantly higher incidence of MACE among snLVEF patients compared to the nLVEF group (15.6% versus 7.4%; P = 0.020). This heightened risk persisted even after adjustment for multiple variables, indicating a strong association between snLVEF and increased MACE risk (HR: 2.346; 95% CI: 1.196-4.602; P = 0.013).

SnLVEF was independently associated with poor prognosis after ACS. Enhanced management strategies for snLVEF patients could potentially reduce the incidence of MACE in ACS patients.

最近，基于表明 LVEF 超过 65% 的个体全因死亡率增加的大量数据集，提出了超正常左心室射血分数 (snLVEF)。然而，LVEF > 65% 在急性冠状动脉综合征 (ACS) 中的影响仍未得到充分研究。

本研究的目的是探讨 ACS 患者超正常左心室射血分数 (snLVEF) 与主要不良心血管事件 (MACE) 之间的相关性。

方法：2013 年 3 月至 2015 年 10 月期间首次接受冠状动脉造影的 874 名 ACS 患者（560 名男性，平均年龄 59.5 ± 10.0；314 名女性，平均年龄 61.5 ± 8.9）被分为 2 组： 正常 LVEF (nLVEF) (55% ≤ EF ≤ 65%) 和 snLVEF (EF > 65%)，根据超声心动图结果。通过收集临床数据和长期随访数据对患者进行术后MACE评估。通过Kaplan-Meier分析和Cox回归分析进一步分析了这种相关性。

随访数据显示，与 nLVEF 组相比，snLVEF 患者的 MACE 发生率显着更高（15.6% vs 7.4%；P = 0.020）。即使在调整多个变量后，这种升高的风险仍然存在，表明 snLVEF 与 MACE 风险增加之间存在很强的相关性（HR：2.346；95% CI：1.196-4.602；P = 0.013）。

SnLVEF 与 ACS 后不良预后独立相关。加强 snLVEF 患者的管理策略可能会降低 ACS 患者 MACE 的发生率。