Predictors of in-hospital heart failure in patients with acute anterior wall ST-segment elevation myocardial infarction. (15th March 2023)

• Record Type: Journal Article
• Authors: Liang, Jingkang; Zhang, Zenghui
• Is Part Of: International journal of cardiology. Volume 375(2023)
• Page Start: 104
• Page End: 109
• Publication Date: 2023-03-15
• Subjects: Myocardial infarction -- Heart failure -- Percutaneous coronary intervention -- Predictor; HF Heart failure -- STEMI ST-segment elevation myocardial infarction -- pPCI Primary percutaneous coronary intervention -- VF Ventricular fibrillation -- CAP Community-acquired pneumonia -- LVEF Left ventricular ejection fraction -- NT-pro-BNP N-terminal pro-brain natriuretic peptide -- RWMA Regional wall motion abnormality -- TIMI Thrombolysis in myocardial infarction -- OR Odds ratio -- CI Confidence interval -- ROC Receiver operating characteristic -- AUC Area under the curve; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2023.01.002
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Heart failure (HF) is a severe complication of acute ST-segment elevation myocardial infarction (STEMI). Its incidence is associated with myocardial infarction location, and it occurs frequently after acute anterior wall STEMI due to the larger infarct size. However, predictors of in-hospital HF in patients with acute anterior wall STEMI are inadequately defined. We aimed to determine potential predictors of HF in patients with acute anterior wall STEMI during hospitalization. Methods: A total of 714 consecutive patients who were diagnosed with acute anterior wall STEMI and underwent primary percutaneous coronary intervention (pPCI) between January 2013 to August 2019 were enrolled retrospectively. We assigned the patients to HF and non-HF groups. The clinical parameters were subjected to univariate analysis and logistic regression analysis to obtain the independent predictors. Results: Among the 714 patients enrolled in the present study (mean age 61.0 ± 13.8 years, men 80.7%), 387 (54.2%) had in-hospital HF. According to a multivariate logistic regression analysis, ventricular fibrillation (VF, OR: 5.66, 95% CI: 2.25–14.23, P < 0.001) was the most striking independent predictor of in-hospital HF. Community-acquired pneumonia (CAP, OR: 4.72, 95% CI: 2.44–9.10, P < 0.001), age (OR: 1.03, 95% CI: 1.01–1.04, P < 0.001), left ventricular ejection fraction (LVEF, OR: 0.96, 95% CI: 0.93–0.97, P < 0.001), and peak N-terminal pro-brain natriuretic peptide (NT-pro-BNP, OR: 1.06, 95% CI: 1.02–1.11, P = 0.006) were also independently associated with in-hospital HF. Conclusion: VF, CAP, age, LVEF, and peak NT-pro-BNP were independently associated with in-hospital HF in patients with acute anterior wall STEMI. Highlights: In anterior ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention, heart failure remains a common complication. Ventricular fibrillation, community-acquired pneumonia, age, left ventricular ejection fraction, and peak N-terminal pro-brain natriuretic peptide were independently associated with in-hospital HF in patients with acute anterior STEMI. Ventricular fibrillation is the strongest independent predictor of heart failure in patients with anterior ST-segment elevation myocardial infarction.