Predictors of Left Ventricular Ejection Fraction Decrease in Patients With ST-Segment Elevation Myocardial Infarction

Area of Science:

• Cardiology
• Biomedical Engineering
• Clinical Research

Background:

• ST-segment elevation myocardial infarction (STEMI) can lead to impaired left ventricular (LV) function.
• Predicting LV ejection fraction (LVEF) is crucial for managing STEMI patients.
• Accurate prediction models can guide therapeutic strategies and improve patient outcomes.

Purpose of the Study:

• To identify key predictors of LVEF in STEMI patients.
• To develop and validate a predictive model for LVEF in this population.
• To stratify STEMI patients based on LVEF for risk-tailored management.

Main Methods:

• Prospective registry study of 138 STEMI patients admitted within 24 hours.
• Biomarker analysis (NT-proBNP, PCSK9, hs-cTnI, CRP) on day 1.
• Serial echocardiography (day 1 and day 10-12) to calculate LVEF.
• Ordinal regression analysis to identify predictors and construct the prognostic model.

Main Results:

• Predictors of lower LVEF included chronic heart failure history, Killip class II-IV acute heart failure, LV dilation, postinfarction aneurysm, and elevated NT-proBNP.
• The developed model demonstrated high sensitivity for predicting reduced LVEF (94.4%) and moderately reduced LVEF (92.9%).
• Model sensitivity for predicting preserved LVEF was 62.5%.

Conclusions:

• STEMI patients with a history of chronic heart failure, acute heart failure (Killip II-IV), LV dilation, postinfarction aneurysm, and elevated NT-proBNP are likely to have reduced LVEF.
• The established model aids in identifying STEMI patients at risk of impaired LV function.
• Early identification of patients with potential for reduced LVEF can facilitate timely interventions.