Related Experiment Video
Updated: Aug 6, 2026
Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
Clinical correlates of early post-PCI left ventricular ejection fraction in patients with STEMI: a single-center
Weicheng Lai1,2, Liangxiu Wu3, Xueer He4
1Department of Cardiology, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, No. 71 Hexi Street, Jianye District, Nanjing, Jiangsu, 210019, China.
Insights
Early left ventricular dysfunction after ST-segment elevation myocardial infarction (STEMI) treatment is linked to the infarct artery location and admission blood pressure. Lipid markers like TG/HDL-C offer limited predictive value for this early dysfunction.
Area of Science:
- Cardiology
- Biomedical Engineering
- Clinical Research
Background:
- Early left ventricular systolic dysfunction is a common complication following primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI).
- This dysfunction is associated with adverse cardiac remodeling and the development of heart failure.
- The role of lipid markers and ratios in predicting early post-PCI ventricular dysfunction, beyond traditional angiographic and hemodynamic factors, is not well-established.
Purpose of the Study:
- To investigate the association between lipid profiles and early left ventricular systolic dysfunction after primary PCI in STEMI patients.
- To identify clinical and lipid-related factors that correlate with left ventricular ejection fraction (LVEF) and the presence of reduced LVEF post-PCI.
- To evaluate the discriminatory ability of lipid markers and ratios in predicting early post-PCI left ventricular dysfunction.
Main Methods:
- A retrospective study of 254 STEMI patients undergoing emergency PCI was conducted.
- Left ventricular ejection fraction (LVEF) was assessed via echocardiography 24-72 hours post-PCI; reduced LVEF was defined as <50%.
- Lipid profiles (LDL-C, HDL-C, TG) were measured on admission, and lipid ratios (LDL-C/HDL-C, TG/HDL-C) were calculated. Multivariable regression models and ROC analysis were employed.
Main Results:
- Reduced LVEF was observed in 17.7% of patients.
- Involvement of the Left Anterior Descending artery (LAD) as the infarct-related artery was significantly more frequent in patients with reduced LVEF.
- LAD-IRA was independently associated with lower LVEF and increased odds of reduced LVEF. Higher admission systolic blood pressure correlated with lower odds of reduced LVEF. The TG/HDL-C ratio showed modest discrimination (AUC=0.605), while LDL-C showed no meaningful discrimination (AUC=0.492).
Conclusions:
- In STEMI patients treated with PCI, the culprit artery territory (specifically LAD) and admission systolic blood pressure are key clinical factors associated with early post-PCI left ventricular dysfunction.
- Lipid markers, particularly the TG/HDL-C ratio, demonstrated limited standalone clinical utility in predicting this early dysfunction.
- These findings are considered exploratory and warrant further investigation to generate hypotheses regarding predictive markers for post-STEMI cardiac function.
Introduction:
Early left ventricular systolic dysfunction after primary percutaneous coronary intervention (PCI) remains common in ST-segment elevation myocardial infarction (STEMI) and is associated with adverse remodeling and heart failure. The clinical relevance of lipid markers and lipid ratios for characterizing early post-PCI ventricular dysfunction beyond angiographic and hemodynamic features remains uncertain.
Methods:
We conducted a single-center retrospective study of consecutive patients with STEMI undergoing emergency PCI at Nanjing BenQ Hospital (2014-2023). LVEF was assessed by transthoracic echocardiography 24-72 h post-PCI, and reduced LVEF was defined as < 50%. Lipids were measured from the first blood sample obtained on admission, and LDL-C/HDL-C and TG/HDL-C were calculated. Multivariable linear and logistic regression models with hierarchical adjustment (Model 2 additionally including log1p-transformed troponin I measured from the first blood sample obtained on admission) were used to identify factors associated with LVEF and reduced LVEF. Discrimination of lipid markers was evaluated using ROC analysis.
Results:
Among 254 patients, 45 (17.7%) had reduced LVEF. LAD as the infarct-related artery (IRA) was more frequent in the reduced-LVEF group (73.3% vs. 48.3%, P = 0.002). LAD-IRA was independently associated with lower LVEF (β = -5.240; P < 0.001) and higher odds of reduced LVEF (OR = 4.005; P < 0.001). Higher systolic blood pressure was associated with lower odds of reduced LVEF (P = 0.026). TG/HDL-C showed modest discrimination (AUC = 0.605), whereas LDL-C showed no meaningful discrimination (AUC = 0.492).
Conclusion:
In PCI-treated STEMI, LAD culprit territory and admission systolic blood pressure were the main clinical correlates of early post-PCI LV dysfunction, whereas TG/HDL-C showed only modest discrimination and limited standalone clinical utility. These findings should be considered exploratory and hypothesis-generating.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Acute Coronary Syndrome I: Introduction