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The long-term prognostic value of E/e' in patients with ST segment elevation myocardial infarction

Jino Park1, Yeo-Jeong Song1, Seunghwan Kim1

  • 1Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.

Indian Heart Journal
|August 17, 2022
PubMed

Insights

A high E/e' ratio (≥15) in ST-segment elevation myocardial infarction (STEMI) patients predicts poor long-term outcomes. This ratio is a stronger predictor of major adverse cardiac events and cardiac death than ejection fraction.

Area of Science:

  • Cardiology
  • Echocardiography
  • Clinical Prognostics

Background:

  • ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular event.
  • Assessing long-term prognosis after STEMI is crucial for patient management.
  • The prognostic value of the E/e' ratio in STEMI patients requires further elucidation.

Purpose of the Study:

  • To evaluate the long-term prognostic significance of the E/e' ratio in patients with STEMI.
  • To determine if the E/e' ratio is a stronger predictor of adverse outcomes than left ventricular ejection fraction (LVEF).

Main Methods:

  • Retrospective analysis of 314 STEMI patients undergoing primary percutaneous coronary intervention.
  • Patients were stratified into two groups based on baseline E/e' ratio: <15 and ≥15.
  • Major adverse cardiac events (MACEs) were tracked for at least three years post-intervention.

Main Results:

  • The E/e' ratio ≥15 group exhibited a significantly higher incidence of MACEs (34.8% vs. 12.7%, p<0.001).
  • Cardiac death rates were substantially higher in the E/e'≥15 group (17.4% vs. 0.4%, p<0.001).
  • Baseline E/e'≥15 was the strongest independent predictor for MACEs (HR 2.597) and cardiac death (HR 27.537), outperforming LVEF.

Conclusions:

  • A baseline E/e' ratio of 15 or higher is a powerful predictor of poor long-term clinical outcomes in STEMI patients post-reperfusion.
  • The E/e' ratio offers significant prognostic information beyond traditional markers like LVEF.
Abstract

Keywords:
E/e’MACEOutcomePrognosisSTEMI

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