Short‐ and long‐term prognostic value of right ventricular function in patients with first acute ST elevation myocardial infarction treated by primary angioplasty

Radwan, Hanan; Hussein, Ekhlas; Refaat, Hesham

doi:10.1111/echo.14974

Cited by 9 publications

(3 citation statements)

References 32 publications

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“…RV free wall LS has emerged as a prognostic factor offering additional prognostic value beyond clinical and echocardiographic data [26]. RV dysfunction assessed by the conventional echocardiographic parameters of RV and RV free wall LS was an independent outcome predictor in an unselected group of 502 STEMI patients [27]. RV GLS has only been assessed in a cohort of 282 patients with inferior STEMI, where it emerged as an independent predictor of MACE, even after adjusting for multiple covariates [28].…”

Section: Discussion and Expected Resultsmentioning

confidence: 99%

Prognostic Implications of Clinical, Laboratory and Echocardiographic Biomarkers in Patients with Acute Myocardial Infarction—Rationale and Design of the ‘‘CLEAR-AMI Study’’

Daios,

Anastasiou,

Moysidis

et al. 2023

JCM

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Background: Acute myocardial infarction (AMI) remains a major cause of death worldwide. Survivors of AMI are particularly at high risk for additional cardiovascular events. Consequently, a comprehensive approach to secondary prevention is necessary to mitigate the occurrence of downstream complications. This may be achieved through a multiparametric tailored risk stratification by incorporating clinical, laboratory and echocardiographic parameters. Methods: The ‘‘CLEAR-AMI Study’’ (ClinicalTrials.gov Identifier: NCT05791916) is a non-interventional, prospective study including consecutive patients with AMI without a known history of coronary artery disease. All patients satisfying these inclusion criteria are enrolled in the present study. The rationale of this study is to refine risk stratification by using clinical, laboratory and novel echocardiographic biomarkers. All the patients undergo a comprehensive transthoracic echocardiographic assessment, including strain and myocardial work analysis of the left and right heart chambers, within 48 h of admission after coronary angiography. Their laboratory profile focusing on systemic inflammation is captured during the first 24 h upon admission, and their demographic characteristics, past medical history, and therapeutic management are recorded. The angioplasty details are documented, the non-culprit coronary lesions are archived, and the SYNTAX score is employed to evaluate the complexity of coronary artery disease. A 24-month follow-up period will be recorded for all patients recruited. Conclusion: The ‘‘CLEAR-AMI” study is an ongoing prospective registry endeavoring to refine risk assessment in patients with AMI without a known history of coronary artery disease, by incorporating echocardiographic parameters, biochemical indices, and clinical and coronary characteristics in the acute phase of AMI.

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Section: Discussion and Expected Resultsmentioning

confidence: 99%

Prognostic Implications of Clinical, Laboratory and Echocardiographic Biomarkers in Patients with Acute Myocardial Infarction—Rationale and Design of the ‘‘CLEAR-AMI Study’’

Daios,

Anastasiou,

Moysidis

et al. 2023

JCM

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“…RVLS > −22% was proved to be superior that TAPSE in the multivariate model. The research that included 520 AMI patients treated with PCI showed that FAC < 35%, TAPSE < 17 mm, RVLS > −17%, s' < 9.5 cm/s, RVMPI > 0.43, and tricuspid regurgitation velocity >2.8 m/s were strong independent predictors of in-hospital MACE and 1-year mortality [70]. Figure 1 (Panel F) demonstrates echocardiography-derived RVLS in patient after AMI.…”

Section: Coronary Artery Diseasementioning

confidence: 99%

The Prognostic Importance of Right Ventricular Longitudinal Strain in Patients with Cardiomyopathies, Connective Tissue Diseases, Coronary Artery Disease, and Congenital Heart Diseases

et al. 2021

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Right ventricular (RV) systolic function represents an important independent predictor of adverse outcomes in many cardiovascular (CV) diseases. However, conventional parameters of RV systolic function (tricuspid annular plane excursion (TAPSE), RV myocardial performance index (MPI), and fractional area change (FAC)) are not always able to detect subtle changes in RV function. New evidence indicates a significantly higher predictive value of RV longitudinal strain (LS) over conventional parameters. RVLS showed higher sensitivity and specificity in the detection of RV dysfunction in the absence of RV dilatation, apparent wall motion abnormalities, and reduced global RV systolic function. Additionally, RVLS represents a significant and independent predictor of adverse outcomes in patients with dilated cardiomyopathy (CMP), hypertrophic CMP, arrhythmogenic RV CMP, and amyloidosis, but also in patients with connective tissue diseases and patients with coronary artery disease. Due to its availability, echocardiography remains the main imaging tool for RVLS assessment, but cardiac magnetic resonance (CMR) also represents an important additional imaging tool in RVLG assessment. The findings from the large studies support the routine evaluation of RVLS in the majority of CV patients, but this has still not been adopted in daily clinical practice. This clinical review aims to summarize the significance and predictive value of RVLS in patients with different types of cardiomyopathies, tissue connective diseases, and coronary artery disease.

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“…2 However, STEMI patients are still at risk for long-term adverse cardiovascular events (MACEs). 3 Studies have shown that current smoking, history of heart failure, and diabetes mellitus are independent predictors of MACEs after STEMI. 4,5 SII and NT-proBNP levels are rarely reported to be associated with MACEs.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Systemic Immune-Inflammation Index and NT-proBNP in Patients with Acute ST-Elevation Myocardial Infarction

Zhu¹,

He²,

Qiu³

et al. 2023

CIA

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Objective Our aim was to assess systemic immune-inflammation index (SII) and NT-proBNP value either in singly or in combination to predict acute ST-elevation myocardial infarction (STEMI) patient prognosis. Methods Analyzed retrospectively the clinical features and laboratory data of STEMI confirmed patients in our hospital from January to December 2020. The levels of SII and NT-proBNP were detected. The Kaplan-Meier approach and Spearman’s rank correlation coefficient were used to construct the overall major adverse cardiac event (MACE) curve. Multivariate Cox regression analysis was applied to detect MACE predictors. In addition, the Delong test and receiver operating characteristic (ROC) curve analyzed each factor performance on its own and composite multivariate index to predict MACEs. Results The MACE group showed statistically significant differences in SII, NT- proBNP in comparison to the non-MACE group ( P =0.003, P <0.001). Based on Kaplan-Meier analysis, SII and NT-proBNP showed positive correlation with MACE (log-rank P < 0.001). SII and NT-proBNP were independent predicting factors for long-term MACEs in multivariate Cox regression analysis ( P <0.001, HR : 2.952, 95% CI 1.565–5.566; P <0.001, HR : 2.112, 95% CI 1.662–2.683). SII and NT-proBNP exhibited a positive correlation ( R = 0.187, P < 0.001) in correlation analysis. According to the ROC statistical analysis, the combination exhibited 78.0% sensitivity and 88.0% specificity in the prediction of MACE. According to the results of the AUC and Delong test, the combined SII and NT-proBNP performed better as a prognostic index than each of the individual factor indexes separately ( Z = 2.622, P = 0.009; Z = 3.173, P < 0.001). Conclusion SII and NT-proBNP were independent indicators of clinical prognosis in acute STEMI patients, and they correlated positively. These factors could be combined to improve clinical prognosis.

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Short‐ and long‐term prognostic value of right ventricular function in patients with first acute ST elevation myocardial infarction treated by primary angioplasty

Cited by 9 publications

References 32 publications

Prognostic Implications of Clinical, Laboratory and Echocardiographic Biomarkers in Patients with Acute Myocardial Infarction—Rationale and Design of the ‘‘CLEAR-AMI Study’’

Prognostic Implications of Clinical, Laboratory and Echocardiographic Biomarkers in Patients with Acute Myocardial Infarction—Rationale and Design of the ‘‘CLEAR-AMI Study’’

The Prognostic Importance of Right Ventricular Longitudinal Strain in Patients with Cardiomyopathies, Connective Tissue Diseases, Coronary Artery Disease, and Congenital Heart Diseases

Prognostic Value of Systemic Immune-Inflammation Index and NT-proBNP in Patients with Acute ST-Elevation Myocardial Infarction

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