Predicting Reduced Left Ventricular Ejection Fraction in Patients With ST-Elevation Myocardial Infarction: Role of...

Area of Science:

• Cardiology
• Critical Care Medicine
• Medical Diagnostics

Background:

• Reduced left ventricular ejection fraction (LVEF) is a key predictor of poor prognosis in ST-elevation myocardial infarction (STEMI).
• Existing risk scores for STEMI patients often lack discriminatory power upon hospital arrival.
• Early identification of high-risk STEMI patients is crucial for effective management.

Purpose of the Study:

• To develop and validate a Quick Forrester Classification (QFC) using respiratory rate (RR) and serum lactate levels.
• To investigate the association between the QFC and reduced LVEF in STEMI patients.
• To assess the QFC's utility in rapid risk stratification upon hospital admission.

Main Methods:

• A retrospective cohort study of 569 STEMI patients from 2018 to 2023.
• Patients were classified into four QFC groups based on RR (<20 or ≥20/min) and lactate (<2.0 or ≥2.0 mmol/L).
• The primary endpoint was LVEF <45% measured by echocardiography before discharge.

Main Results:

• QFC Class-4 (high RR and high lactate) showed the highest proportion of reduced LVEF (26%).
• Class-4 was independently associated with reduced LVEF compared to Class-1 (OR 2.47).
• The QFC effectively stratified STEMI patients based on risk for reduced LVEF.

Conclusions:

• The QFC, utilizing only RR and lactate, is significantly associated with reduced LVEF in STEMI.
• This bedside tool facilitates rapid identification of high-risk STEMI patients.
• The QFC complements existing strategies for timely multidisciplinary care in STEMI.