Influencing factors and prognostic value of left ventricular systolic dysfunction in patients with complete occlusion of the left anterior descending artery reperfused by primary percutaneous coronary intervention

Abstract

Background: The aim of this study was to perform a retrospective analysis of patients with acute anterior wall ST-segment elevation myocardial infarction (AAW-STEMI) whose left anterior descending (LAD) artery was completely occluded and reperfused by primary percutaneous coronary intervention (PPCI) and to determine the influencing factors and prognostic value of left ventricular systolic dysfunction (LVSD) in the acute phase of acute myocardial infarction (AMI). Methods: A total of 304 patients with AAW-STEMI were selected. The selected patients were divided into two groups: the preserved left ventricular ejection fraction (pLVEF) group (LVEF≥50%, n=185) and the reduced left ventricular ejection fraction (rLVEF) group (LVEF<50%, n=119). The influencing factors of LVSD and their predictive value for LVSD were analyzed. Patients were followed up (median follow-up: 47 months [interquartile range: 27 to 64 months]) by examining outpatient records and via telephone. The predictive value of LVSD for the survival of patients with AAW-STEMI was analyzed. Results: Age, heart rate (HR) at admission, number of ST-segment elevation leads (STELs), peak creatine kinase (CK) and symptom to wire-crossing (STW) time were independent risk factors for LVSD. Peak CK had the strongest predictive value for LVSD. LVSD is an independent adverse factor for long-term prognosis in patients with AAW-STEMI discharged after PPCI. Conclusions: Age, HR at admission, number of STELs, peak CK, and STW time may be used to identify patients with a high risk of heart failure (HF) in a timely manner and initiate early standard therapy for patients with AAW-STEMI whose LAD artery was completely occluded and reperfused by PPCI. Incident LVSD in the acute phase after AAW-STEMI was significantly associated with a trend toward increased mortality at follow-up.