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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

  • Authors:
    • Dong‑Hee Kim
    • Chang‑Bum Park
    • Eun‑Sun Jin
    • Hui‑Jeong Hwang
    • Il Suk Sohn
    • Jin‑Man Cho
    • Chong‑Jin Kim

  • View Affiliations

  • Published online on: March 19, 2018     https://doi.org/10.3892/etm.2018.5962
  • Pages: 4089-4096

  • Copyright: © Kim et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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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.
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May-2018
Volume 15 Issue 5

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Spandidos Publications style
Kim DH, Park CB, Jin ES, Hwang HJ, Sohn IS, Cho JM and Kim CJ: Predictors of decreased left ventricular function subsequent to follow-up echocardiography after percutaneous coronary intervention following acute ST-elevation myocardial infarction. Exp Ther Med 15: 4089-4096, 2018.
APA
Kim, D., Park, C., Jin, E., Hwang, H., Sohn, I.S., Cho, J., & Kim, C. (2018). Predictors of decreased left ventricular function subsequent to follow-up echocardiography after percutaneous coronary intervention following acute ST-elevation myocardial infarction. Experimental and Therapeutic Medicine, 15, 4089-4096. https://doi.org/10.3892/etm.2018.5962
MLA
Kim, D., Park, C., Jin, E., Hwang, H., Sohn, I. S., Cho, J., Kim, C."Predictors of decreased left ventricular function subsequent to follow-up echocardiography after percutaneous coronary intervention following acute ST-elevation myocardial infarction". Experimental and Therapeutic Medicine 15.5 (2018): 4089-4096.
Chicago
Kim, D., Park, C., Jin, E., Hwang, H., Sohn, I. S., Cho, J., Kim, C."Predictors of decreased left ventricular function subsequent to follow-up echocardiography after percutaneous coronary intervention following acute ST-elevation myocardial infarction". Experimental and Therapeutic Medicine 15, no. 5 (2018): 4089-4096. https://doi.org/10.3892/etm.2018.5962