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Predictors of left ventricular ejection function decline in young patients with ST-segment elevation myocardial

Ibrahim Yildiz1, Ibrahim Rencüzoğulları2, Yavuz Karabağ2

  • 1Adana Çukurova State Hospital, Department of Cardiology - Adana, Turkey.

Revista Da Associacao Medica Brasileira (1992)
|June 29, 2022
PubMed

Insights

In young ST-segment elevation myocardial infarction (STEMI) patients, prolonged ischemia and specific lesion characteristics predict reduced left ventricular ejection fraction (LVEF). Statin use may help prevent LVEF decline, which is linked to higher long-term mortality.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Myocardial Infarction Research

Background:

  • Reduced left ventricular ejection fraction (LVEF) after ST-segment elevation myocardial infarction (STEMI) is a significant mortality predictor in young adults.
  • Understanding factors influencing LVEF decline is crucial for improving outcomes in this population.

Purpose of the Study:

  • To identify predictors of LVEF reduction in young STEMI patients (≤45 years).
  • To evaluate long-term mortality rates in young STEMI patients with and without reduced LVEF (≤40%).

Main Methods:

  • Retrospective analysis of 411 young STEMI patients (<45 years) undergoing primary percutaneous coronary intervention.
  • Patients were stratified into two groups based on LVEF: ≤40% (n=72) and >40% (n=339).
  • Comparison of clinical, procedural, and outcome data between the two LVEF groups.

Main Results:

  • Independent predictors of low LVEF included statin use, white blood cell count, C-reactive protein, peak creatine kinase-MB, prolonged ischemia time, left anterior descending artery infarction, proximal/ostial lesion location, and no-reflow.
  • Long-term mortality was significantly higher in the LVEF ≤40% group (18.1%) compared to the LVEF >40% group (2.4%; p<0.001).

Conclusions:

  • Lesion characteristics (LAD, proximal location), no-reflow, and prolonged ischemia are key determinants of LVEF decline in young STEMI patients.
  • Demographic, hematological parameters, and coronary disease severity were less influential on LVEF reduction.
  • Statin use may play a preventive role in maintaining LVEF in young STEMI patients.
Abstract

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