Association of Acute Change in Left Ventricular End Diastolic Pressure with In-Hospital Mortality after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction

Abstract

Objective: To investigate the relationship between acute changes in Left Ventricular End Diastolic Pressure (LVEDP) and inhospital mortality in patients with ST-segment Elevation Myocardial Infarction (STEMI) who underwent Primary
Percutaneous Coronary Intervention (PPCI).

Study Design: Analytical Cross-sectional study.

Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi
Pakistan, from Sep 2022 to Dec 2022.

Methodology: Patients (n=104) with STEMI who underwent primary PCI of the culprit coronary artery with deployment of
drug eluting stent were recruited through consecutive sampling. Left ventricular end-diastolic pressure values were measured pre-and Post-Primary Percutaneous Coronary Intervention. Mean, median and standard deviation were obtained for continuous variables while percentages and frequencies for categorical variables. Chi square test was applied to check
association. p<0.05 was considered significant.

Results: Out of 104 patients, Males were 62(59.6%) and mean age was 64.04±10.04 years. Hypertensive patients were 85(81.7%) and 67(64.4%) were diabetic. The median LVEDP was 21 mmHg while the mean pre- and post-intervention left ventricular end-diastolic pressure was 21.39±3.42mmHg and 13.54±4.50mmHg respectively, with mean reduction of 7.85±3.33 mmHg. Following Primary Percutaneous Coronary Intervention, patients who exhibited elevated LVEDP experienced an in-hospital mortality rate of 7(70%), (p<0.001).
Conclusion: Patients who did not exhibit a notable decrease in left ventricle end-diastolic pressure after intervention were at an increased risk of in-hospital mortality. This heightened risk was strongly associated with elevated levels of left ventricle
end-diastolic pressure.