Role of stroke volume in patients presenting with uncomplicated anterior STEMI

Area of Science:

• Cardiology
• Echocardiography
• Clinical Prognostics

Background:

• Stroke volume (SV) is an established echocardiographic marker, yet its prognostic role in ST-segment elevation myocardial infarction (STEMI) remains understudied.
• Anterior STEMI patients with severe left ventricle (LV) systolic dysfunction represent a high-risk population where novel prognostic markers are needed.

Purpose of the Study:

• To evaluate stroke volume (SV) in uncomplicated anterior STEMI patients.
• To assess the prognostic significance of SV in anterior STEMI patients with severe LV systolic dysfunction.

Main Methods:

• Retrospective analysis of 616 anterior STEMI patients undergoing primary percutaneous coronary intervention.
• Echocardiographic measurement of stroke volume and left ventricular ejection fraction (LVEF) during in-hospital admission.
• Multivariate analysis and receiver operating characteristic (ROC) analysis to determine the association of SV with 12-month cardiovascular mortality.

Main Results:

• The average LVEF was 39±11% and SV was 62±18 mL.
• A modest relationship between SV and LVEF was observed (r=0.33), which was not significant in patients with severe LV dysfunction (r=0.11).
• In patients with severe LV systolic dysfunction, lower SV was independently associated with increased 12-month cardiovascular mortality (HR 0.92; p=0.015), with an AUC of 0.80 and 99% negative predictive value.

Conclusions:

• Stroke volume is a readily available and useful echocardiographic marker for prognosis assessment in anterior STEMI patients with severe LV systolic dysfunction.
• SV effectively identifies patients likely to survive despite severe LV systolic dysfunction, offering high certainty.
• This marker aids in risk stratification and clinical decision-making for this vulnerable patient group.