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The Association Between Left Ventricular Global Function Index and Major Adverse Cardiovascular Events Linked to
Ahmet Kivrak1, Veysel Ozan Tanik2, Cagatay Tunca2
1Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Insights
Systemic inflammation impacts left ventricular global function index (LVGFI) in acute coronary syndrome (ACS). Lower LVGFI predicts major adverse cardiac events (MACEs) in STEMI and NSTEMI patients.
Area of Science:
- Cardiology
- Biomarkers
- Echocardiography
Background:
- Systemic inflammation is implicated in acute coronary syndromes (ACS).
- Left ventricular global function index (LVGFI) assessed by echocardiography reflects cardiac function.
- The relationship between inflammation and LVGFI in ACS requires further elucidation.
Purpose of the Study:
- To investigate the association between systemic inflammation markers (CRP, SII) and LVGFI in ACS patients.
- To evaluate the diagnostic performance of LVGFI for predicting major adverse cardiac events (MACEs) across the ACS spectrum (STEMI vs. NSTEMI).
Main Methods:
- 1697 ACS patients (794 STEMI, 903 NSTEMI) were analyzed.
- LVGFI was measured using echocardiography.
- Inflammatory markers C-reactive protein (CRP) and systemic immune inflammation index (SII) were assessed.
Main Results:
- STEMI patients had lower LVGFI and higher CRP/SII levels compared to NSTEMI patients.
- Higher LVGFI quartiles correlated with lower inflammation markers, particularly in STEMI.
- LVGFI thresholds for predicting 3-year MACEs were <21.8% for STEMI and <25.4% for NSTEMI.
Conclusions:
- LVGFI is associated with systemic inflammation in ACS.
- LVGFI demonstrates diagnostic utility for MACE prediction in both STEMI and NSTEMI.
- Integrating inflammatory status and ACS type enhances cardiac function and prognosis assessment using LVGFI.
Abstract:
We aimed to investigate the association between systemic inflammation and the left ventricular global function index (LVGFI) and evaluate the diagnostic performance of LVGFI for MACEs across the acute coronary syndrome (ACS) spectrum. A total of 1697 patients (794 with ST-segment elevation myocardial infarction [STEMI] and 903 with non-STEMI [NSTEMI]) were evaluated. The LVGFI was calculated using echocardiography. Inflammatory status was assessed with C-reactive protein (CRP) and the systemic immune inflammation index (SII). MACEs were defined as non-fatal re-infarction, repeated revascularization of the target vessel, and all-cause mortality at a 3-year follow-up. While the STEMI group exhibited lower LVGFI values compared with the NSTEMI group (P < .001), it had a higher SII level (P < .001) and CRP level (P = .021). The association between higher LVGFI quartiles and lower levels of systemic inflammation was more pronounced in the STEMI group. The threshold value of LVGFI to predict MACEs was <21.8% (Sensitivity = 79.2%, Specificity = 68.7%) for STEMI, while it was <25.4% (Sensitivity = 77.4%, Specificity = 70.8%) for NSTEMI. Considering both the inflammatory status and ACS spectrum when evaluating LVGFI could provide a more comprehensive assessment of cardiac function and prognosis in ACS patients.
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