Background: ST-segment elevation myocardial infarction (STEMI) is the most acute manifestation of coronary artery disease, with substantial morbidity and mortality. This study aimed to assess the relationship between selected baseline and post-PCI ECG variables and the presence of LVSD 6 months after a first STEMI. Methods: This prospective study was conducted on 191 patients who underwent percutaneous coronary intervention (PCI) for a first STEMI. The patients were divided into two groups: Group 1 (LVSD Group): 34 patients who developed LVSD six months post-STEMI. Group 2 (Non-LVSD Group): 157patients who did not develop LVSD six months after the STEMI, with an LVEF >40%. Results: LVEF, prevalence of presence of reciprocal ST-segment depression ≥ 1mm and ST-segment resolution and the prevalence of ST-segment resolution (≥50%) was significantly reduced in LVSD group compared to non-LVSD group (P