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

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.