Association of Systolic BP to LVED Pressure Ratio with In-Hospital Mortality in STEMI Patients Undergoing PPCI

Objective: To determine the association of Systolic Blood Pressure to Left Ventricular End-Diastolic Pressure ratio with in-hospital mortality in ST-Elevation Myocardial Infarction patients undergoing Primary Percutaneous Coronary Intervention. Study Design: Analytical, Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology, National Institute of Heart Diseases, Rawalpindi Pakistan, from Apr-Jun 2023. Methodology: One hundred and ninety-eight patients who underwent Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction patients presenting within 12-hours were included using non-probability consecutive sampling technique. Patients were divided into two groups (Group-I= SBP/LVEDP ratio ≤4; Group-II= SBP/LVEDP ratio >4). SBP and LVEDP were measured during Primary Percutaneous Coronary Intervention. Demographic and clinical data, including risk factors and laboratory findings, were collected and SBP/LVEDP ratio was calculated. Study variables were compared among groups by applying independent t-test and Chi-square test. p-value<0.05 was kept as significant. Results: Among the study sample of 198, 126(63.6%) were males and females were 72(36.3%), mean age was 61.31±9.16 years. 21(10.6%) patients had SBP/LVEDP ratio≤4 (Group-I), while 177(89.3%) patients had SBP/LVEDP ratio>4 (Group-II). Group-I showed a higher prevalence of heart failure 5(23.8%), lower ejection fraction (35.48±7.56%), longer duration of in-hospital stay (8.76±2.48 days) (p<0.05), and higher TIMI scores (9.28±1.10) compared to Group-II. In-hospital mortality was also higher in Group-I (33.3%), compared to Group-II (6.2%) (p<0.05). Conclusion: The SBP/LVEDP ratio≤4 has significantly predicted increased risk of adverse outcomes and in-hospital mortality in STEMI patients who underwent Primary Percutaneous Coronary Intervention. This ratio may serve as a marker of compromised c....