Elevated left ventricular end-diastolic pressure (> 22 mm Hg) was significantly associated with higher in-hospital mortality (3.7% vs. 0.4%) in patients with non-ST-segment elevation myocardial infarction.
Observational (n=367)
No
Does elevated LVEDP (> 22 mm Hg) predict in-hospital mortality in patients with NSTEMI?
Elevated LVEDP (> 22 mm Hg) is significantly associated with higher in-hospital mortality and heart failure in patients with NSTEMI, serving as a useful prognostic marker for risk stratification.
Absolute Event Rate: 3.7% vs 0.4%
p-value: p=0.03
BACKGROUND: Elevated left ventricular end-diastolic pressure (LVEDP) has been reported to predict an increased mortality in patients with ST-segment elevation myocardial infarction. However, its prognostic value in patients with non-ST-segment elevation myocardial infarction (NSTEMI) remains unclear. METHODS: We performed a retrospective analysis of NSTEMI patients who underwent coronary angiography between January 2013 and June 2014. We excluded patients who did not undergo LVEDP measurements. Baseline and angiographic characteristics, in-hospital heart failure as well as in-hospital mortality were recorded. RESULTS: After exclusion, 367 patients were included in the final analysis. The median (interquartile range) LVEDP was 19 mm Hg (14 - 24 mm Hg). By receiver operating characteristic curve analysis, the optimal cutoff value for predicting in-hospital mortality was 22 mm Hg (area under the curve 0.80, sensitivity 80%, and specificity 71%). Of 367 patients, 109 patients (29.7%) had LVEDP > 22 mm Hg. Patients with LVEDP > 22 mm Hg had a greater number of comorbidities. There was no statistically significant difference in the rate of multi-vessel disease. Patients with LVEDP > 22 mm Hg had a significantly higher rate of in-hospital heart failure (22.0% vs. 13.2%, P = 0.03) and in-hospital mortality (3.7% vs. 0.4%, P = 0.03) than those with LVEDP ≤ 22 mm Hg. CONCLUSION: Elevated LVEDP was significantly associated with a higher in-hospital mortality in patients with NSTEMI.
Kobayashi et al. (2015) conducted an observational in Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) (n=367). Elevated left ventricular end-diastolic pressure (LVEDP > 22 mm Hg) vs. LVEDP ≤ 22 mm Hg was evaluated on In-hospital all-cause mortality (p=0.03). Elevated left ventricular end-diastolic pressure (> 22 mm Hg) was significantly associated with higher in-hospital mortality (3.7% vs. 0.4%) in patients with non-ST-segment elevation myocardial infarction.