What are the predictors of in-hospital left ventricular dysfunction in patients with first acute STEMI undergoing successful primary PCI?
A novel 10-variable risk score can help quickly identify patients at high risk for developing significant in-hospital left ventricular dysfunction after a first acute STEMI treated with primary PCI.
Background: Left ventricular dysfunction after ST segment elevation myocardial infarction (STEMI) is the most important factor affecting morbidity and mortality. The primary objective of reperfusion therapy is to restore epicardial flow and to reperfuse the myocardial tissue. However, in some cases lack of microvascular reperfusion and, consequently, significant left ventricular (LV) dysfunction persist despite the rapid and sustained restoration of blood flow. Early in the course of STEMI, therapies that may harm patients who develop LV dysfunction, such as beta-blockers, are often administered.Aim of the work: construct a predictive score of the risk of developing left ventricular dysfunction in patients with STEMI.Patient and methods: This study was done in Cardiology department, Zagazig University on 100 patients; 78 males (78%) positive likelihood ratios for LV dysfunction in these groups were 2.9, 2.1, and 2.4, respectively.Conclusions: 10 key predictors of in-hospital LV dysfunction after STEMI were identified; a risk score based on these predictors helps to quickly identify patients presenting with STEMI who are at the highest risk for developing significant LV dysfunction and could guide optimal therapeutic choices.
Naguib et al. (Wed,) studied this question.