Key result
RV dysfunction in anterior STEMI linked to ~184% higher acute heart failure and cardiogenic shock risk.
Why the study?
In anterior STEMI, attention is focused mainly on the left ventricle, and the predictive significance of right ventricular dysfunction has been frequently neglected.
Does right ventricular dysfunction worsen in-hospital outcomes in patients with acute anterior STEMI?
Cohort (n=77)
No
Does right ventricular dysfunction worsen in-hospital outcomes in patients with acute anterior STEMI?
Absolute Event Rate: 69.4% vs 24.4%
p-value: p=< 0.05
Right ventricular dysfunction in patients with acute anterior STEMI is associated with significantly worse in-hospital outcomes, including higher rates of cardiogenic shock and acute heart failure.
RV dysfunction signals higher in-hospital risk in anterior STEMI; leaves open whether targeted strategies improve outcomes.
Background: In anterior ST-segment elevation myocardial infarction (STEMI), attention paid mainly to the left ventricle. The predictive significance of right ventricular (RV) dysfunction in patients with anterior STEMI has been frequently neglected. In this study, we evaluated the prognostic effect of RV dysfunction on in-hospital outcomes in patients with first anterior STEMI. Methods: Present study is based on the analysis of 77 patients admitted to Coronary care unit of the Sir Salimullah Medical College & Mitford Hospital, Dhaka during April, 2019 to March, 2020, with acute anterior wall myocardial infarction. 12 lead ECG with thorough physical examination was done along with echocardiographic assessment of RV and LV function within index hospitalization, preferably within 24 hours of admission. Patients were divided into two groups depending on right ventricular function assessment. Group I included anterior MI with right ventricular dysfunction and group II included anterior MI without right ventricular dysfunction. In hospital outcomes were observed and compared between two groups. Results: Patients with RV dysfunction had statistically significant higher incidence of cardiogenic shock (22.2 % vs. 2.4%, p < 0.05), acute heart failure (69.4% vs. 24.4%, p < 0.05), arrhythmia (11.1% vs. 0.0%, p < 0.05), increase length of hospital stay in patients of RV dysfunction group. In-hospital mortality was non significantly higher in RV dysfunction group (8.3% vs. 2.4%, p > 0.305). Conclusion: In this study, we observed that in-hospital outcomes were worse in patients with anterior STEMI with RV dysfunction and demands more intense invasive management. Thus, special care should be given for the assessment function of right ventricle in anterior STEMI. Cardiovasc j 2022; 14(2): 128-134
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Hossain et al. (2022) conducted a cohort in Acute anterior wall myocardial infarction (STEMI) (n=77). Right ventricular dysfunction vs. No right ventricular dysfunction was evaluated on Acute heart failure (p=< 0.05). Right ventricular dysfunction in patients with anterior STEMI was associated with significantly higher incidences of acute heart failure (69.4% vs 24.4%) and cardiogenic shock (22.2% vs 2.4%).
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