Key result
LVEF < 50% predicts ~9-fold greater ischemic cardiomyopathy risk in AMI patients after PCI.
Why the study?
Many patients with acute myocardial infarction suffer from heart failure due to progressive ischemic left ventricular remodeling, prompting an investigation into predictors of ischemic cardiomyopathy after successful percutaneous intervention.
What are the independent echocardiographic predictors of ischemic cardiomyopathy development in patients with acute myocardial infarction who underwent successful percutaneous coronary intervention?
Observational (n=547)
What are the independent echocardiographic predictors of ischemic cardiomyopathy development in patients with acute myocardial infarction who underwent successful percutaneous coronary intervention?
Odds Ratio: 8.722 (95% CI 2.986–25.478)
p-value: p=<0.001
In patients with acute myocardial infarction undergoing successful PCI, LVEF < 50%, LV end-diastolic dimension > 55 mm, and E/e’ ≥ 15 are independent predictors of developing ischemic cardiomyopathy.
May support post-PCI risk stratification in AMI; hypothesis-generating for targeted interventions to prevent ischemic cardiomyopathy.
Background/Aims: Many patients with acute myocardial infarction (AMI) suffer from heart failure due to progressive ischemic left ventricular (LV) remodeling. This study investigated the predictors of ischemic cardiomyopathy (ICMP) in patients with AMI who underwent successful percutaneous intervention.Methods: A total of 547 patients with AMI were divided into two groups: ICMP (n = 66, 67.1 ± 11.9 years, 78.8% males) and non-ICMP (n = 481, 62.5 ± 12.2 years, 70.1% males).Results: On echocardiography, the LVEF was significantly decreased (41.7 ± 10.5 vs. 55.4 ± 10.3%, p < 0.001) but the LV end-diastolic (54.1 ± 7.2 vs. 49.3 ± 5.3 mm, p < 0.001) and systolic (42.1 ± 8.0 vs. 33.5 ± 6.0 mm, p < 0.001) dimensions significantly increased in the ICMP group compared with the non-ICMP group. According to multivariate logistic regression analysis, LVEF < 50% (odds ratio [OR] 8.722, 95% confidence interval [CI] 2.986–25.478, p < 0.001), LV end-diastolic dimension > 55 mm (OR 4.511, 95% CI 1.561–13.038, p = 0.005), and ratio of early mitral inflow velocity to mitral annular early diastolic velocity (E/e’) ≥ 15 (OR 3.270, 95% CI 1.168–9.155, p = 0.024) were independent predictors of ICMP development.Conclusions: The present study demonstrates that a larger LV size, lower LV function, and increased E/e’ (≥ 15) were independent predictors of ICMP. Therefore, the development of ICMP should be carefully monitored in AMI patients with these features.
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Kim et al. (2020) conducted an observational in Acute myocardial infarction (n=547). LVEF < 50% vs. LVEF ≥ 50% was evaluated on Development of ischemic cardiomyopathy (ICMP) (OR 8.722, 95% CI 2.986-25.478, p=<0.001). LVEF < 50% (OR 8.722; 95% CI 2.986-25.478; p<0.001), LV end-diastolic dimension > 55 mm, and E/e' ≥ 15 were independent predictors of ischemic cardiomyopathy in AMI patients after PCI.
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