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Prognostic Value of Aortic Stiffness in Patients After ST-Elevation Myocardial Infarction

Hans-Josef Feistritzer1, Gert Klug1, Sebastian J Reinstadler1

  • 1University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Austria.

Journal of the American Heart Association
|September 10, 2017
PubMed

Insights

High aortic stiffness, measured by aortic pulse wave velocity (PWV), predicts adverse outcomes in ST-elevation myocardial infarction patients. Adding PWV to risk models significantly improves early risk stratification for major adverse cardiac and cerebrovascular events (MACCE).

Area of Science:

  • Cardiovascular Medicine
  • Clinical Cardiology
  • Biomedical Engineering

Background:

  • High aortic stiffness is a known predictor of morbidity and mortality in general and specific patient populations.
  • The prognostic significance of aortic stiffness in ST-elevation myocardial infarction (STEMI) survivors remains largely unknown.

Purpose of the Study:

  • To investigate the prognostic value of aortic stiffness in patients following a first acute ST-elevation myocardial infarction.
  • To determine if aortic stiffness improves risk stratification for major adverse cardiac and cerebrovascular events (MACCE) in this cohort.

Main Methods:

  • Prospective observational study of 160 STEMI patients.
  • Aortic pulse wave velocity (PWV) measured via cardiac MRI 2-4 days post-infarction.
  • Follow-up for major adverse cardiac and cerebrovascular events (MACCE) over a median of 1.2 years.

Main Results:

  • High PWV (>7.3 m/s) was associated with significantly lower MACCE-free survival (log-rank P=0.003).
  • PWV >7.3 m/s independently predicted MACCE (HR ≥3.5, P≤0.018) after multivariable adjustment.
  • Adding PWV to established risk factors improved risk reclassification for MACCE (Net Reclassification Improvement = 0.11, P<0.001).

Conclusions:

  • Increased aortic stiffness is an independent predictor of MACCE in STEMI patients.
  • Aortic stiffness assessment enhances early risk stratification beyond traditional risk factors.
Abstract

Keywords:
ST‐elevation myocardial infarctionaortic stiffnesscardiac magnetic resonanceprognosispulse wave velocity

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