Prevalence, Correlates, and Prognostic Significance of In-Hospital Transthoracic Echocardiography Use in Stable Acute Myocardial Infarction

Little is known regarding in-hospital transthoracic echocardiography (TTE) utilization and its prognostic implications among stable patients with acute myocardial infarction (AMI). We aimed to explore patient and disease characteristics, treatment strategies, and mid-term outcome following uncomplicated AMI according to TTE use during the hospitalization phase. A single-center, retrospective analysis was conducted that included consecutive adult individuals admitted for AMI who did not develop cardiogenic shock and who survived the index hospitalization. Stratified by in-hospital TTE administration status, the cohort was evaluated for all-cause mortality at 1-year post-discharge. Overall, 15,971 subjects (mean age 66 ± 14 years, 69.8% males, 46.1% with ST-elevation myocardial infarction) were analyzed, of whom 12,610 (79.0%) underwent TTE. TTE use correlated with younger age, fewer comorbidities, greater odds of invasive revascularization and intensive coronary care unit management, and lengthier hospital stay. Ultimately, it was associated with a lower rate, cumulative incidence, and—independent of accompanying prognostic markers—risk of all-cause mortality (n = 1032/12,619, 8.2% vs. n = 804/3361, 23.9%, p < 0.001; Log-Rank p < 0.001; adjusted hazard ratio 0.75, 95% confidence interval 0.67–0.83, p < 0.001). Similar results were observed within a 6270-patient, 1-1 propensity score-matched sub-cohort. To conclude, in our experience, in-hospital TTE administered for stable AMI patients was associated with improved mid-term survival. Further research is needed to re-evaluate the present-day recommendation’s Level of Evidence C for its routine use.