Key result
An E/e' ratio ≥15 was associated with a significantly higher rate of major adverse cardiac events compared to E/e' <15 in STEMI patients (34.8% vs. 12.7%; HR 2.597; 95% CI 1.294-5.211; P=0.007).
Why the study?
The long-term prognostic value of the E/e' ratio in patients with ST-segment elevation myocardial infarction required evaluation.
Does a baseline E/e' ratio ≥15 predict long-term major adverse cardiac events in patients with STEMI undergoing primary coronary intervention?
Cohort (n=314)
Does a baseline E/e' ratio ≥15 predict long-term major adverse cardiac events in patients with STEMI undergoing primary coronary intervention?
Hazard Ratio: 2.597 (95% CI 1.294–5.211)
Absolute Event Rate: 34.8% vs 12.7%
p-value: p=0.007
In patients with STEMI undergoing primary PCI, a baseline echocardiographic E/e' ratio ≥15 is a strong independent predictor of long-term MACE and cardiac death.
E/e' ratio may refine post-STEMI risk stratification after PCI; leaves open incremental value in validated models.
OBJECTIVES: This study aimed to evaluate the long-term prognostic value of E/e' ratio in patients with ST-segment elevation myocardial infarction (STEMI). METHODS: We retrospectively assessed 314 patients who underwent primary coronary interventions between January 2010 and December 2015. The included patients were classified into two groups according to the E/e' ratios: E/e'<15 (n = 245) and E/e'≥15 (n = 69). We investigated the incidence of major adverse cardiac events (MACEs) from the event to the final follow-up period of at least three years. RESULTS: A total of 55 cases of MACEs occurred during the follow-up. The E/e'≥15 group showed a significantly higher rate of MACEs than the E/e'<15 group (34.8% vs. 12.7%, p < 0.001). Among the MACE, the percentage of cardiac deaths (17.4% vs. 0.4%, p < 0.001) was higher in the E/e'≥15 group than in the E/e'<15 group. In the multivariable model, E/e'≥15 was demonstrated as the strongest prognostic factor for MACEs (hazard ratio [HR], 2.597; 95% confidence interval [CI], 1.294-5.211; p = 0.007) and cardiac death (HR, 27.537; 95% CI, 3.287-230.689; p = 0.002), while left ventricular ejection fraction (LVEF) was not. Neither the discrepancy of systolic nor diastolic function between initial and follow-up echocardiography affected the overall prevalence of MACEs. A disparity was observed between the two groups, with a significant increase in the rate of MACEs in the E/e'≥15 group (log-rank test, p < 0.001). CONCLUSION: The baseline E/e'≥15 in patients with STEMI after successful reperfusion is the strongest predictor of poor long-term clinical outcomes among those analyzed.
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Park et al. (2022) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=314). E/e'≥15 vs. E/e'<15 was evaluated on major adverse cardiac events (MACEs) (HR 2.597, 95% CI 1.294-5.211, p=0.007). An E/e' ratio ≥15 was associated with a significantly higher rate of major adverse cardiac events compared to E/e' <15 in STEMI patients (34.8% vs. 12.7%; HR 2.597; 95% CI 1.294-5.211; P=0.007).
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