Prolonged pain-to-balloon time still impairs midterm left ventricular function following STEMI

Area of Science:

• Cardiology
• Cardiovascular Medicine
• Medical Research

Background:

• ST-elevation myocardial infarction (STEMI) requires prompt reperfusion to mitigate long-term heart failure.
• Assessing left ventricular ejection fraction (LVEF) post-STEMI is crucial for predicting patient outcomes.
• This study examines LVEF in contemporary STEMI patients at a leading tertiary care center.

Purpose of the Study:

• To evaluate the proportion of STEMI patients with impaired LVEF at 1-year follow-up.
• To identify predictors of reduced LVEF in STEMI patients treated under current advanced healthcare standards.
• To understand the long-term impact of STEMI on cardiac function.

Main Methods:

• Analysis of 130 STEMI patients presenting for the first time with coronary artery disease.
• Left ventricular ejection fraction (LVEF) assessment via echocardiography at admission, discharge, and 1-year follow-up.
• Statistical analysis, including logistic regression, to determine independent predictors of reduced LVEF (<50%) at 1 year.

Main Results:

• At 1-year follow-up, 45% of STEMI patients exhibited reduced LVEF.
• Anterior wall myocardial infarction (OR 3.2) and increasing pain-to-balloon times (Q2: OR 15.7, Q4: OR 33.7) were independently associated with reduced LVEF.
• Initial LVEF was reduced in 94% of patients, decreasing to 69% at discharge and 45% at 1 year.

Conclusions:

• A significant proportion of STEMI patients have persistent LVEF reduction at 12 months despite optimal care.
• Pain-to-balloon times over 2 hours and anterior STEMI remain key predictors of long-term left ventricular dysfunction.
• Improving healthcare system efficiency and public awareness is vital to reduce treatment delays and enhance long-term STEMI outcomes.