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Left ventricular hypertrophy on long-term cardiovascular outcomes in patients with ST-elevation myocardial infarction
Jin-Sun Park1, Jeong-Sook Shin1, You-Hong Lee1
1a Department of Cardiology , Ajou University School of Medicine , Suwon , Korea.
Insights
Left ventricular hypertrophy (LVH) significantly worsens survival in ST-elevation myocardial infarction (STEMI) patients. This condition independently predicts higher mortality risk after successful coronary intervention.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Research
Background:
- Left ventricular hypertrophy (LVH) is linked to adverse cardiovascular events in hypertensive individuals.
- The prognostic value of LVH in ST-elevation myocardial infarction (STEMI) patients remains unclear.
Purpose of the Study:
- To investigate the prognostic impact of LVH in patients who have experienced STEMI.
Main Methods:
- Analysis of clinical outcomes in 30-day STEMI survivors undergoing coronary intervention (2003-2009).
- LVH defined by LV mass index (LVMI) >115 g/m² (male) or >95 g/m² (female).
- Assessment of major adverse cardiovascular events (MACE) within 5 years.
Main Results:
- 51% of 418 patients had LVH; survival was significantly worse in the LVH group (p=0.024).
- LVH independently associated with increased all-cause mortality risk (OR, 2.37; p=0.028).
- Severe LVH independently associated with higher all-cause mortality (OR, 5.110; p=0.001).
Conclusions:
- LVH is associated with increased adverse clinical outcomes in STEMI survivors post-coronary intervention.
Background:
Left ventricular hypertrophy (LVH) had been associated with increased adverse cardiovascular events in hypertensive patients. Prognostic significance of LVH in patients with ST-elevation myocardial infarction (STEMI) is not established. This study aimed to investigate prognostic impact of LVH on the patients with STEMI.
Methods:
We analyzed the data and clinical outcomes of 30-day survivors with STEMI who underwent successful coronary intervention from 2003 to 2009. Definition of LVH was LV mass index (LVMI) >115 g/m(2) in male and >95 g/m(2) in female. Patients were classified into a LVH group and a non-LVH group. Occurrence of major adverse cardiovascular events (MACE; death, recurrent MI, target vessel revascularization (TVR)) within 5 years was evaluated.
Results:
We enrolled 418 patients and mean follow-up duration was 43 ± 17 months. Two hundred and fourteen patients (51%) had LVH. The survival of the patients with LVH was significantly worse than the patients without LVH (log-rank p = 0.024). In a multivariate regression model, the presence of LVH was independently associated with increased risk for all-cause mortality (OR, 2.37; 95% CI, 1.096-5.123, p = 0.028). When the end points were analyzed based on LVH severity, all-cause mortality was significantly correlated with LVH severity (p = 0.011). The severe LVH was independently associated with increased risk for all-cause mortality (OR, 5.110; 95% CI, 1.454-17.9, p = 0.001).
Conclusion:
LVH was associated with increased rate of adverse clinical outcomes in 30-day survivors after STEMI, who underwent successful coronary intervention.
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