Avaliable data for adverce cardiac events prognostication after ST segment elevation myocardial infarction

Abstract

The treatment of acute myocardial infarction (AMI) is aimed at the long‑term survival of patients, so attention should be given to predicting adverse outcomes, specifically the development of heart failure, recurrent AMI, cardiovascular death, and so on. The combination of various data obtained in recent decades has helped improve prognosis, but challenges with long‑term survival after ST segment elevation myocardial infarction (STEMI) still exist.
 Objective — to find the optimal combination of data collected from patients with STEMI and prospectively analyzed during one‑year observation to improve the quality of prognostication.
 Materials and methods. One hundred and twenty‑eight enrolled patients visited research center to clinical examination and estimation of left ventricular (LV) function in 365±14 days follow up period after STEMI. End points such as major adverce cardiac events (MACE) — composite of cardiovascular death, recurrent MI, newly diagnosed heart failure, rhythm, and conduction disturbances were estimated. Primary percutaneous coronary intervention was successful, and all included patients had TIMI (Thrombolysis In Myocardial Infarction) >2. Patients was divided into two cohorts depending on the presence of MACE: global longitudinal strain and mechanical dispersion are independent factors of it (p=0.0006 and p <0.0001respectively).
 Results. We found the optimal combination of different data for prognostication of adverce outcome after 1 year after STEMI, among them occurred global longitudinal strain, left atrium volume index, left ventricular end diastolic diameter, mechanical dispersion, LV ejection fraction. They all reflect different hemodynamic sides of LV remodeling after STEMI.
 Conclusions. The model is simple and avaliable for use in medical practice.