Key result
Improvement in both left ventricular ejection fraction and wall motion score index at one year post-PCI was associated with a significantly lower risk of MACE compared to no improvement (7.8% vs 17.1%).
Why the study?
The prognostic significance of changes in LVEF and wall motion score index (WMSI) in patients with myocardial infarction remained unclear.
Does improvement in both LVEF and WMSI at one year post-PCI predict a lower risk of MACE in patients with acute myocardial infarction?
Cohort (n=3,510)
Yes
Does improvement in both LVEF and WMSI at one year post-PCI predict a lower risk of MACE in patients with acute myocardial infarction?
Background The prognostic significance of changes in left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) in patients with myocardial infarction remains unclear. Methods This study evaluated whether changes in LVEF and WMSI can predict clinical outcomes and LV remodeling in post-AMI patients. Using data from the Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH), 3,510 AMI patients who underwent percutaneous coronary intervention (PCI) were retrospectively analyzed. LVEF and WMSI were assessed via echocardiography at baseline and one-year post-PCI. The primary outcome was major cardiovascular adverse events (MACE), a composite of all-cause death, recurrent myocardial infarction (MI), and rehospitalization for heart failure at three years. Results Among 3,510 AMI patients, 1,561 (44.5%) showed improvement in both LVEF and WMSI at one year after PCI, 1,150 (32.8%) experienced improvement in either LVEF or WMSI, while 799 (22.8%) had deterioration in both. The incidence of MACE was significantly lower in patients with improvement in both LVEF and WMSI (7.8% vs. 12.5% vs. 17.1%, P < 0.001). These patients also exhibited the highest rate of LV reverse remodeling and the lowest rate of adverse remodeling. Both the random forest and logistic regression models identified changes in LVEF and WMSI as significant predictors of MACE and LV remodeling. Conclusion In AMI patients, improvement in both LVEF and WMSI post-PCI was associated with a lower risk of MACE and a higher likelihood of LV reverse remodeling. These findings highlight the prognostic value of LVEF and WMSI changes in guiding long-term management strategies.
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Jung et al. (2025) conducted a cohort in Acute myocardial infarction (AMI) (n=3,510). Improvement in both LVEF and WMSI at 1 year post-PCI vs. No improvement in LVEF or WMSI was evaluated on Major adverse cardiovascular events (MACE), a composite of all-cause mortality, recurrent MI, and rehospitalization for heart failure at 3 years (HR 2.57, 95% CI 1.99-3.32, p=<0.001). Improvement in both left ventricular ejection fraction and wall motion score index at one year post-PCI was associated with a significantly lower risk of MACE compared to no improvement (7.8% vs 17.1%).
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