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Predictors of decreased left ventricular function subsequent to follow-up echocardiography after percutaneous coronary intervention following acute ST-elevation myocardial infarction
- Source :
- Experimental and Therapeutic Medicine
- Publication Year :
- 2016
-
Abstract
- The preferred treatment for patients with ST elevation myocardial infarction (STEMI) is primary percutaneous coronary intervention (PCI). However, not all patients improve or maintain heart function following primary PCI, and certain patients may experience decreased heart function. The present study investigated factors associated with left ventricular (LV) dysfunction, and improvement or deterioration of LV ejection fraction (LVEF) at follow-up echocardiography following successful primary PCI. The clinical outcomes following primary PCI were also investigated. The present study assessed 4,044 patients who underwent primary PCI following a diagnosis of STEMI between January 2008 and March 2012. A total of 1,736 patients who underwent echocardiography between 30 days and 1 year after STEMI and PCI, and who had completed clinical follow-up, were included in the present study. A total of 243 patients (14.0%) demonstrated LV dysfunction at follow-up echocardiography. Multivariate analysis revealed that LV dysfunction (≤40%) at index STEMI, LVEF at index admission, renal insufficiency (creatinine ≥1.4 mg/dl), peak creatine kinase (CK) and peak CK MB isoenzyme (CKMB) were independent predictors of LV dysfunction at follow-up. Independent predictors for the deterioration of LVEF at follow-up were dyslipidemia, LVEF at index admission, LVEF ≤40% at index admission, peak CK and peak troponin-I. Furthermore, being male, having no history of coronary artery disease, pre-thrombolysis in myocardial infarction (TIMI) flow, LVEF at index admission, LVEF ≤40% at index admission, peak CKMB and peak troponin I were independent predictors of LVEF improvement at follow-up. One-year major adverse cardiac events were significantly increased in the LV dysfunction group compared with patients who did not exhibit LV dysfunction according to Cox regression analysis (13.6 vs. 20.4%; P=0.017). Therefore, the present study may provide valuable prognostic information for clinicians to advise patients who experience LV dysfunction despite having undergone successful primary PCI. Additional management is required in patients with these high-risk features following STEMI.
- Subjects :
- Cancer Research
medicine.medical_specialty
medicine.medical_treatment
030204 cardiovascular system & hematology
030218 nuclear medicine & medical imaging
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Immunology and Microbiology (miscellaneous)
Internal medicine
Angioplasty
Medicine
Myocardial infarction
cardiovascular diseases
Ejection fraction
business.industry
Percutaneous coronary intervention
angioplasty
General Medicine
Articles
medicine.disease
coronary occlusion
surgical procedures, operative
myocardial infarction
Coronary occlusion
Conventional PCI
Cardiology
business
TIMI
Subjects
Details
- ISSN :
- 17920981
- Volume :
- 15
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Experimental and therapeutic medicine
- Accession number :
- edsair.doi.dedup.....52b9b50474f453e39b75fdde9bffcfd8