Key result
Left ventricular hypertrophy in patients with acute myocardial infarction was associated with a higher rate of major adverse cardiac events compared to normal geometry (25.5% vs. 16.0%, p=0.001).
Why the study?
The impact of left ventricular hypertrophy and abnormal left ventricular geometry on clinical outcomes in patients with acute myocardial infarction was not clear.
Does left ventricular hypertrophy and its subtypes predict major adverse cardiac events in Korean patients with acute myocardial infarction?
Cohort (n=852)
Does left ventricular hypertrophy and its subtypes predict major adverse cardiac events in Korean patients with acute myocardial infarction?
In Korean patients with acute myocardial infarction, left ventricular hypertrophy, particularly the eccentric hypertrophy subtype, is a significant predictor of major adverse cardiac events.
LVH was associated with higher MACE risk after AMI; leaves open whether routine assessment refines stratification in Korean patients.
Background/Aims: Left ventricular hypertrophy (LVH) on clinical outcomes in patients with acute myocardial infarction (AMI) is not clear. This study was performed to investigate the effect of abnormal left ventricular geometry on clinical outcomes in Korean patients with AMI.Methods: A total of 852 consecutive patients with AMI were divided into two groups: normal left ventricular geometry (n = 470; 389 males) and LVH (n = 382; 214 males) groups. Major adverse cardiac events (MACEs) were defined as cardiac death, recurrent myocardial infarction, and rehospitalization.Results: During the clinical follow-up period of 21 ± 7.8 months, MACEs developed in 173 patients (20.0%), and the rate was higher in the LVH than normal left ventricular geometry groups (25.5% vs. 16.0%, respectively, p = 0.001). According to Kaplan-Meier survival curves, the MACE-free survival rate was significantly lower in the LVH group than in the left ventricular geometry group (p = 0.008). The rates of MACEs and all-cause mortality differed among the AMI with concentric remodeling, concentric hypertrophy, and eccentric hypertrophy subgroups (11.2% vs. 15.5% vs. 22.1%, respectively, p = 0.046). Eccentric hypertrophy was a predictive factor of MACE according to Cox proportional hazards analysis (hazard ratio 1.804, confidence interval 1.034-3.148, p = 0.038).Conclusions: LVH is a predictor of poor outcomes in patients with AMI, and eccentric hypertrophy is associated with a worse prognosis compared with concentric remodeling and concentric hypertrophy. Therefore, Korean patients with AMI and LVH, especially eccentric hypertrophy, require more careful observation and intensive treatment.
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Kim et al. (2020) conducted a cohort in Acute myocardial infarction (n=852). Left ventricular hypertrophy vs. Normal left ventricular geometry was evaluated on Major adverse cardiac events (cardiac death, recurrent myocardial infarction, and rehospitalization) (p=0.001). Left ventricular hypertrophy in patients with acute myocardial infarction was associated with a higher rate of major adverse cardiac events compared to normal geometry (25.5% vs. 16.0%, p=0.001).
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