Value of Transthoracic Echocardiography in Predicting Short Term Major Adverse Cardiac Events after ST Elevation Myocardial Infarction in COVID 19 Era

Abstract

Abstract Background Acute myocardial infarction remains a leading cause of morbidity and mortality worldwide. In the era of COVID 19, early risk stratification and identification of high-risk patients with ST-segment elevation myocardial infarction are of great significance in prognosis, and in guiding diagnosis and treatment decisions. Measuring left ventricular peak systolic global longitudinal strain may be a useful addition to ejection fraction using echocardiography. Aim of the Study Is to evaluate different parameters of echocardiography in predicting major adverse cardiac events in patients after acute ST-segment elevation myocardial infarction in the era of Covid 19. Methods and patients This study included 97 patients who presented with acute STsegment elevation myocardial infarction within 12 hours of onset of chest pain and managed by primary percutaneous coronary intervention, it was performed in Ain Shams university hospitals from January 2021 to June 2021. Echocardiography was used to measure ejection fraction and left ventricular strain parameters Results The study included 97 patients, 55 % of which presented with anterior STEMI. Out of the whole group 29 patients (21%) developed MACE at 3 months follow up. Within the whole group, the mean ejection fraction was (44.04±6.07% VS .40.07±6.52% p = 0.007) and the mean global longitudinal strain was (-12.56±3.61% VS -10.1±3.25% p=0.002). Based on CT chest finding, 33 patients were Covid 19 patients who were younger in age, included significantly more females and had significantly higher Killip score as compared to the non covid patients. Among COVID-19 patients, the mean ejection fraction was (46.11±5.29% VS 40.6±7.11% p=0.02) and the mean global longitudinal strain was (-13.17±3.35% VS 10.35±3.38% p=0.026). At 3 months follow up, 39% of the Covid patients had MACE as compared to 25% of the non covid patients P = 0.0001. Conclusion In the era of COVID 19, young patients with female gender who suffered from STEMI were more likely to be COVID 19 patients and were liable to develop MACE at 3 months follow up. However, their LV EF and GLS were comparable to non-COVID 19 patients Ethical approval this study protocol was approved by the local ethics committee with a consent was obtained from all participants. Abbreviations MACE: major adverse cardiac events; LV: left ventricle; GLS: global longitudinal strain; STEMI: ST elevation myocardial infarction