Key result
Elevated left ventricular end-diastolic pressure (≥16 mmHg) in STEMI patients was strongly associated with higher BMI, advanced Killip class, increased coronary artery severity, and reduced ejection fraction.
Why the study?
Clinical and biological factors affecting LVEDP in STEMI patients undergoing coronary angiography and PPCI were not well defined.
What clinical and biological factors are associated with elevated LVEDP (≥16mmHg) in STEMI patients undergoing PPCI?
Observational (n=96)
Non-random
No
What clinical and biological factors are associated with elevated LVEDP (≥16mmHg) in STEMI patients undergoing PPCI?
Absolute Event Rate: 30% vs 24%
p-value: p=<0.001
In STEMI patients undergoing PPCI, elevated LVEDP (≥16 mmHg) is strongly associated with higher BMI, advanced Killip class, greater coronary disease severity, and worse cardiac biomarkers.
Objective: To determine the clinical & biological factors affecting Left Ventricular End Diastolic Pressure(LVEDP) in ST-Segment Elevation Myocardial Infarction (STEMI) patients undergoing coronary angiography followed by Primary Percutaneous Coronary Intervention(PPCI). Study Design: Quasi-Experimental study. Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Feb-Aug 2024. Methodology: Ninety-six STEMI patients regardless of gender were enrolled through consecutive sampling. Baseline variables like Hs-Trop I, BMI, Ejection Fraction, Mean Arterial Pressure, and Killip Class were noted upon patient arrival at emergency room. LVEDP was measured using pigtail catheter during coronary-angiography and patients were classified non-randomly in two Groups: LVEDP<16mmHg (Group-A) and ≥16mmHg (Group-B). Coronary artery disease severity was assessed using the Gensini score. Clinical parameters and biological parameters were compared between Groups. Results: Ninety-six patients [males: 66(68.8%), females: 30(31.2%)] with composite mean age 63.26±7.99 years were enrolled in study. For LVEDP, 51(53.1%) patients had values <16mmHg, while 45(46.9%) had LVEDP≥16mmHg. BMI was significantly higher in Group-B [30.00(24.00-34.00) kg/m² vs 24.00(22.00-26.00) kg/m²; p<0.001] and all the patients classified as Killip class III/IV had LVEDP≥16 mmHg (p<0.001). There was significant difference in mean values of Gensini score, EF, NT-proBNP, Hs Trop-I, MAP, TG and eGFR with comparatively higher mean values in Group-B patients except EF and eGFR (p<0.01). Correlation was significant between LVEDP and aforementioned clinical parameters except TRG (p<0.001). Conclusion: LVEDP is strongly associated with higher BMI, advanced Killip class, and increased coronary artery severity. It also correlates with elevated cardiac biomarkers and reduced ejection fraction,..
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Sadiq et al. (2025) conducted an observational in ST-Segment Elevation Myocardial Infarction (STEMI) (n=96). Elevated Left Ventricular End-Diastolic Pressure (≥16 mmHg) vs. LVEDP <16 mmHg was evaluated on Body mass index (kg/m²) (p=<0.001). Elevated left ventricular end-diastolic pressure (≥16 mmHg) in STEMI patients was strongly associated with higher BMI, advanced Killip class, increased coronary artery severity, and reduced ejection fraction.
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