DYNAMIC OF LEFT VENTRICULAR SYSTOLIC FUNCTION DURING MEDIUM-TERM FOLLOW-UP PERIOD OF PATIENTS WITH MYOCARDIAL INFARCTION

Abstract

Acute coronary syndrome is the most common cause for admission in coronary care unit with the highest risk of death and adverse events and it is responsible for about 70% of all hospital admissions. Patients with acute coronary syndrome are diverse group in which the seriousness of underlying coronary artery disease, its prognosis and response to treatment are significantly different. Myocardial infarction remains one of the most important causes for morbidity and mortality in the world. Aim of the study is to prove association between echocardiography parameters in development of major adverse cardiac events in patients with acute myocardial infarction, treated with percutaneous coronary intervention. Material and methods: This study was designed as longitudinal, prospective observational cohort study in which were included 150 patients, hospitalized for acute coronary syndrome in University Clinic of Cardiology in the time period of September 2018 till March 2019. Inclusion criteria: patients, hospitalized for acute coronary syndrome in forementioned period, who were willing to participate in the study and have given signed informed consent. Exclusion criteria: patients who were not consented to participate in the study, patients who suffered in-hospital mortality over the index hospitalization, and patients with previously known heart failure and/or AMI were excluded from the study. Results: In order to analyze the dynamics of left ventricular systolic function expressed through ejection fraction we did analysis of the global left ventricular systolic function at the time of indexed event and I the period of 3 – 6 months, with condition that there is no new major adverse cardiac event, who would influence it. Patients were classified into three groups, according to the guidelines of European Society for Cardiology for treatment of heart failure from 2012, 2016 and 2021: patients with ejection fraction <40% (HFrEF); patients with ejection fraction of 40 – 50% (HFmrEF) and patients with ejection fraction >50% (HFpEF). In multivariant analysis (logistics regression conditional) in the final model with Chi square 62,916 (p=0,000012 and 79.5% accurate prediction) three independent variables were singled out: in hospital morbidity, natriuretic peptide and initial ejection fraction (%). Conclusion: Independent predictors of improved left ventricular ejection fraction in patients with acute myocardial infarction after successful percutaneous coronary intervention are in hospital morbidity, natriuretic peptide and initial ejection fraction (%).