Relation between Left Ventricular Wall Stress after Primary Percutaneous Coronary Intervention and Adverse Cardiovascular Events in Non-Diabetic Patients with Acute Anterior ST-Segment Elevation Myocardial Infarction | ||||
| International Journal of Medical Arts | ||||
| Article 11, Volume 5, Issue 11, November 2023, Page 3867-3874 PDF (1.02 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ijma.2023.186447.1595 | ||||
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| Authors | ||||
Islam Mohamed Moussa  1; Mohamed Sayed Bashandy 1; Hamouda Abdel khalek EL-bahnasy 1; Ahmed AL-HABBAA 2
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| 1Department of Cardiology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt | ||||
| 2Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Acute ST-segment elevation myocardial infarction [STEMI] results in left ventricular adverse remodeling [LVR]. Increased left ventricular wall stress [LVWS] after Myocardial infarction [MI] initiates this process. Predicting the risk of future major adverse cardiovascular events [MACE] after STEMI has been a subject of great interest. There is a lack of imaging-based data for risk stratifying post-STEMI patients' clinical outcomes at this time. As a result, improvements in echocardiography are urgently needed to identify objectively measurable echocardiographic markers for improved risk stratification. The Aim of the work: This study aimed to study the relation between echocardiography-derived LVWS in non-diabetic patients presented with first acute anterior STEMI who underwent primary percutaneous coronary intervention with the MACE. Patients and Methods: The current study was a prospective cohort study that took place between January 2022 and November 2022 and included 78 non-diabetic patients who presented with acute anterior STEMI treated by primary PCI. LVWS was calculated within 72 hours by pre-discharge echocardiogram using volume-based formulas. Patients were divided into two groups based on their three months follow-up data following primary PCI; Group I: MACE-negative, and Group II: MACE-positive. Results: MACE-positive patients [n=18] had significantly higher end-systolic wall stress [ESWS] levels 94.95 ± 31.27 vs 77.20 ± 24.37 in MACE-negative patients [P value = 0.013*]. A receiver operating characteristics [ROC] curve was performed for the ESWS [KPa] as a predictor for MACE. The findings revealed an area under the curve of 0.674, the cut-off value for predicting MACE = 85.35 [KPa], with 66.97% sensitivity, 65% specificity, 86.7% Negative predictive value, 36.4 % positive predictive Value [P value = 0.026]. Conclusion: Echocardiography-based left ventricular systolic wall stress is a possibly useful prognostic tool for risk-stratifying non-diabetic STEMI patients early after MI and predicting MACE. | ||||
| Keywords | ||||
| Left Ventricular Wall Stress; Percutaneous Coronary Intervention; Acute Anterior ST-Segment Elevation | ||||
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