The Effect of Management Strategy of ST Segment Elevation Myocardial infarction in Elderly on LV remodeling and Clinical Outcome

Abstract

Acute ST-segment elevation myocardial infarction (STEMI) is the acute injury may evolve in the left ventricularremodeling despite effective coronary revascularization and optimal medical therapy and leads to advanced heart failure.Theaim of the present study was to assess the effect of management strategy of ST segment elevation myocardial infarction inelderly on LV remodeling and clinical outcome.This study included 150 elderly patients above 60 years old with ST segmentelevation myocardial infarction referred to the Coronary care unit, Benha University Hospital.They classified into 3groups:patients who treated with conservative therapy(Group I),patients who treated with primary percutaneousintervention(Group II) and patients who treated with fibrinolytic therapy(Group III). Standard two-dimensionalechocardiography,TDI derived velocity and speckle tracking and 3D echocardiography were used to assess LV remodeling andclinical outcome.Patients of group I were significantly older than those of group II and group III(p value˂0.001). Male genderwas more prevalent in patients of 3 groups (P value ˂0.001).Early diastolic mitral annular velocity (e) was significantlyreduced in patients of group I and group II compared with patients of group III(p value˂0.001) and the mitral E/e ratio wassignificantly higher in patients of group I and group II compared with patients of group III (p value ˂ 0.001).There was nodifference in management strategy of ST myocardial infarction patients as regarding conservative therapy, primary coronaryintervention and fibrinolytic therapy.