Key result
Higher relative wall thickness (RWT PW) was independently associated with a lower risk of major adverse cardiac events (HR 0.74 per 0.1 increase) at 60 months in patients with ST-segment elevation myocardial infarction.
Why the study?
The prognostic value of relative wall thickness (RWT) in patients with ST-segment elevation myocardial infarction (STEMI) was unclear.
Does relative wall thickness predict long-term clinical outcomes in patients with STEMI?
Observational (n=866)
No
Does relative wall thickness predict long-term clinical outcomes in patients with STEMI?
Relative wall thickness calculated using posterior wall thickness (RWTPW) is a reliable predictor of long-term adverse outcomes in patients with non-anterior STEMI.
May refine STEMI risk stratification; leaves open incremental value and need for prospective validation.
Objective The study aimed to evaluate the prognostic value of relative wall thickness (RWT) in the patients with ST-segment elevation myocardial infarction (STEMI). Methods A total of 866 patients with STEMI admitted in Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from November 2010 to December 2018 were enrolled in the current study retrospectively. Three methods were used to calculate RWT: RWTPW, RWTIVS+PW and RWTIVS. The included patients were divided according to the median values of RWTPW, RWTIVS+PW, and RWTIVS, respectively. Survival analysis were performed with Kaplan–Meier plot and multivariate Cox proportional hazard model was established to evaluate the adjusted hazard ratio of the three kinds of RWT for all cause death, cardiac death and MACE (major adverse cardiac death). Results There was no significance for the survival analysis between the low and high groups of RWTPW, RWTIVS+PW and RWTIVS at 30 days and 12 months. Nonetheless, the cumulative incidence of all cause death and cardiac death in the low group of RWTPW and RWTIVS+PW was higher than those in the high group at 60 months. The cumulative incidence of MACE in the low group of RWTPW was higher than the high group at 60 months. Multivariate Cox regression model showed that RWTPW were inversely associated with long-term cardiac death and MACE in STEMI patients. In the subgroup analysis, three calculations of RWT had no predictive value for the patients with anterior myocardial infarction. By contrast, RWTPW was the most stable independent predictor for the long-term outcomes of the patients with non-anterior myocardial infarction. Conclusion RWTPW, RWTIVS+PW and RWTIVS had no predictive value for the long-term clinical outcomes of patients with anterior myocardial infarction, whereas RWTPW was a reliable predictor for all cause death, cardiac death and MACE in patients with non-anterior myocardial infarction.
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Zhang et al. (2023) conducted an observational in ST-segment elevation myocardial infarction (n=866). Relative wall thickness (RWT PW) vs. Lower relative wall thickness was evaluated on Major adverse cardiac events (MACE) at 60 months (HR 0.74, 95% CI 0.57-0.98, p=0.030). Higher relative wall thickness (RWT PW) was independently associated with a lower risk of major adverse cardiac events (HR 0.74 per 0.1 increase) at 60 months in patients with ST-segment elevation myocardial infarction.
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