Yildiz I, Rencüzoğulları I, Karabağ Y, Karakayali M, Artac I, Gurevin MS. Predictors of left ventricular ejection function decline in young patients with ST-segment elevation myocardial infarction.
Rev Assoc Med Bras (1992) 2022;
68:802-807. [PMID:
35766695 PMCID:
PMC9575903 DOI:
10.1590/1806-9282.20220033]
[Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/20/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE:
A decrease in the left ventricular ejection fraction (≤40%) in the setting of
ST-segment elevation myocardial infarction is a significant predictor of
mortality in the young ST-segment elevation myocardial infarction
population. In this study, we aimed to investigate the predictors of left
ventricular ejection fraction reduction and evaluate the long-term mortality
rates in young ST-segment elevation myocardial infarction patients with or
without decreased left ventricular ejection fraction.
METHODS:
We enrolled retrospectively 411 consecutive ST-segment elevation myocardial
infarction patients aged 45 years or below who underwent primary
percutaneous coronary intervention. Young ST-segment elevation myocardial
infarction patients were divided into two groups according to their left
ventricular ejection fraction (≤40%, n=72 and >40%, n=339), which were
compared with each other.
RESULTS:
Statin use, white blood cell count, C-reactive protein, peak creatine
kinase-MB, prolonged ischemia time, left anterior descending artery-related
infarction, proximally/ostial located lesion, and no-reflow were
independently associated with low left ventricular ejection fraction.
Additionally, long-term mortality was considerably higher in the left
ventricular ejection fraction ≤40% group than those in the left ventricular
ejection fraction>40% group (18.1% versus 2.4%; p<0.001).
CONCLUSIONS:
In young ST-segment elevation myocardial infarction patients, lesion
properties (left anterior descending lesion, proximally located lesion),
no-reflow, and prolonged ischemia time appeared to be important determinants
for the left ventricular ejection fraction decline, rather than coronary
disease severity or demographic and hematological parameters. Statin use may
be preventive in the development of left ventricular ejection fraction
decline in young ST-segment elevation myocardial infarction patients.
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