Elsevier

International Journal of Cardiology

Volume 375, 15 March 2023, Pages 104-109
International Journal of Cardiology

Predictors of in-hospital heart failure in patients with acute anterior wall ST-segment elevation myocardial infarction

https://doi.org/10.1016/j.ijcard.2023.01.002Get rights and content
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open access

Highlights

  • In anterior ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention, heart failure remains a common complication.

  • Ventricular fibrillation, community-acquired pneumonia, age, left ventricular ejection fraction, and peak N-terminal pro-brain natriuretic peptide were independently associated with in-hospital HF in patients with acute anterior STEMI.

  • Ventricular fibrillation is the strongest independent predictor of heart failure in patients with anterior ST-segment elevation myocardial infarction.

Abstract

Background

Heart failure (HF) is a severe complication of acute ST-segment elevation myocardial infarction (STEMI). Its incidence is associated with myocardial infarction location, and it occurs frequently after acute anterior wall STEMI due to the larger infarct size. However, predictors of in-hospital HF in patients with acute anterior wall STEMI are inadequately defined. We aimed to determine potential predictors of HF in patients with acute anterior wall STEMI during hospitalization.

Methods

A total of 714 consecutive patients who were diagnosed with acute anterior wall STEMI and underwent primary percutaneous coronary intervention (pPCI) between January 2013 to August 2019 were enrolled retrospectively. We assigned the patients to HF and non-HF groups. The clinical parameters were subjected to univariate analysis and logistic regression analysis to obtain the independent predictors.

Results

Among the 714 patients enrolled in the present study (mean age 61.0 ± 13.8 years, men 80.7%), 387 (54.2%) had in-hospital HF. According to a multivariate logistic regression analysis, ventricular fibrillation (VF, OR: 5.66, 95% CI: 2.25–14.23, P < 0.001) was the most striking independent predictor of in-hospital HF. Community-acquired pneumonia (CAP, OR: 4.72, 95% CI: 2.44–9.10, P < 0.001), age (OR: 1.03, 95% CI: 1.01–1.04, P < 0.001), left ventricular ejection fraction (LVEF, OR: 0.96, 95% CI: 0.93–0.97, P < 0.001), and peak N-terminal pro-brain natriuretic peptide (NT-pro-BNP, OR: 1.06, 95% CI: 1.02–1.11, P = 0.006) were also independently associated with in-hospital HF.

Conclusion

VF, CAP, age, LVEF, and peak NT-pro-BNP were independently associated with in-hospital HF in patients with acute anterior wall STEMI.

Keywords

Myocardial infarction
Heart failure
Percutaneous coronary intervention
Predictor

Abbreviations

HF
Heart failure
STEMI
ST-segment elevation myocardial infarction
pPCI
Primary percutaneous coronary intervention
VF
Ventricular fibrillation
CAP
Community-acquired pneumonia
LVEF
Left ventricular ejection fraction
NT-pro-BNP
N-terminal pro-brain natriuretic peptide
RWMA
Regional wall motion abnormality
TIMI
Thrombolysis in myocardial infarction
OR
Odds ratio
CI
Confidence interval
ROC
Receiver operating characteristic
AUC
Area under the curve

Cited by (0)

All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.