Frequency of Left Ventricular Function Decline in Patients Undergoing Primary Percutaneous Coronary Intervention (PCI) for St Segment Elevation Myocardial Infarction (STEMI)
DOI:
https://doi.org/10.51253/pafmj.v75iSUPPL-7.13611Keywords:
Left Ventricular Function, Primary PCI, STEMIAbstract
Objective: To determine the frequency of left ventricular function decline in patients undergoing primary PCI for STEMI.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Department of Cardiology, Punjab Institute of Cardiology, Lahore Pakistan, from Dec 2024 to Jun 2025.
Methodology: This study was done after taking ethical approval from IRB of Punjab Institute of Cardiology, Lahore. This study was done on 66 patients diagnosed with acute STEMI undergoing primary PCI after taking informed consent. Data collection was done using pre-designed proforma. >5% decrease in ejection fraction as compared to pre PCI at follow up (48 hours post PCI and 4 weeks) was defined as decline in LV function. Data analysis was performed using SPSS version 26, with p-value <0.05 considered significant.
Results: LV function decline was observed in 28.8% participants, with significantly higher frequency was observed in those who presented late and had multiple vessel disease p= 0.047 and 0.001, respectively. The LVEF before PCI (53.27±3.67%), after PCI (52.10±3.91%), and at four weeks follow-up (51.66±4.32%), indicating gradual decline in LVEF over time.
Conclusion: This study highlights that significant proportion of patient’s experience decline in left ventricular function following primary PCI for STEMI. The findings underscore the critical impact of delayed presentation and presence of multivessel coronary artery disease on post-procedural LV performance. These results emphasize the importance of early intervention and comprehensive assessment of coronary anatomy to optimize long-term cardiac function and outcomes in STEMI patients undergoing PCI.
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References
1. Nikus K, Birnbaum Y, Fiol-Sala M, Rankinen J, de Luna AB. Conduction disorders in the setting of acute STEMI. Current Cardiol Rev 2021; 17(1): 41-49.
https://doi.org/10.2174/1573403X16666200702121937
2. Safiri S, Karamzad N, Singh K, Carson-Chahhoud K, Adams C, Nejadghaderi SA, et al. Burden of ischemic heart disease and its attributable risk factors in 204 countries and territories, 1990–2019. Eur J Preve Cardiol 2022; 29(2): 420-431.
https://doi.org/10.1093/eurjpc/zwab213
3. Kazmi T, Nagi M, Razzaq S, Hussnain S, Shahid N, Athar U. Burden of noncommunicable diseases in Pakistan. East Mediterr Health J 2022; 28(11): 798-804.
https://doi.org/10.26719/emhj.22.08
4. Mihajlović D, Maksimović ŽM, Dojčinović B, Banjac N. Acute coronary syndrome (STEMI, NSTEMI and unstable angina pectoris) and risk factors, similarities and differences. Scripta Medica 2020; 51(4): 252-260.
https://doi.org/10.5937/scriptamed51-27722
5. Partow-Navid R, Prasitlumkum N, Mukherjee A, Varadarajan P, Pai RG. Management of ST elevation myocardial infarction (STEMI) in different settings. Int J Angiol 2021; 30(1): 67-75.
https://doi.org/10.1055/s-0041-1723944
6. Milasinovic D, Nedeljkovic O, Maksimovic R, Sobic-Saranovic D, Dukic D, Zobenica V, et al. Coronary microcirculation: the next frontier in the management of STEMI. J Clin Med 2023; 12(4): 1602.
https://doi.org/10.3390/jcm12041602
7. Schäfer A, König T, Bauersachs J, Akin M. Novel therapeutic strategies to reduce reperfusion injury after acute myocardial infarction. Curr Probl Cardiol 2022; 47(12): 101398.
https://doi.org/10.1016/j.cpcardiol.2022.101398
8. Boulet J, Mehra MR. Left ventricular reverse remodeling in heart failure: remission to recovery. Structural Heart 2021; 5(5): 466-481.
https://doi.org/10.1080/24748706.2021.1954275
9. Pahlm U, Ostenfeld E, Seemann F, Engblom H, Erlinge D, Heiberg E, et al. Evolution of left ventricular function among subjects with ST-elevation myocardial infarction after percutaneous coronary intervention. BMC Cardiovasc Dis 2020; 20(1): 309.
https://doi.org/10.1186/s12872-020-01540-y
10. Ma C, Luo H, Fan L, Liu X, Gao C. Heart failure with preserved ejection fraction: an update on pathophysiology, diagnosis, treatment, and prognosis. Braz J Med Biological Res 2020; 53(7): e9646. https://doi.org/10.1590/1414-431X20209646
11. Kim DH, Park CB, Jin ES, Hwang HJ, Sohn IS, Cho JM, et al. Predictors of decreased left ventricular function subsequent to follow-up echocardiography after percutaneous coronary intervention following acute ST-elevation myocardial infarction. Exp Ther Med 2018; 15(5): 4089-4096.
https://doi.org/10.3892/etm.2018.5962
12. Tamrakar R, Rajbhandari R, KC SS. TIMI (Thrombolysis in Myocardial Infraction) flow grade in ST Elevation Myocardial Infarction after Primary Percutaneous Intervention. Europasian J Med Sci 2021; 3(1): 60-65.
https://nepjol.info/index.php/ejms/article/view/39269
13. Liu C, Guo M, Cui Y, Wu M, Chen H. Incidence and predictors of left ventricular function change following ST-segment elevation myocardial infarction. Front Cardiovasc Med 2023; 10(3): 1-7. https://doi.org/10.3389/fcvm.2023.1079647
14. Chimed S, van der Bijl P, Lustosa R, Fortuni F, Montero-Cabezas JM, Ajmone Marsan N, et al. Functional classification of left ventricular remodelling: prognostic relevance in myocardial infarction. ESC Heart Failure 2022; 9(2): 912-924.
https://doi.org/10.1002/ehf2.13802
15. Khademi R, Jafari M, Rahmanian M, Taherkhani M. Echocardiographic Evaluation of Left Ventricular Function Six Weeks Post-Primary Percutaneous Coronary Intervention: A Prospective Study. J Clin Cardiol 2024; 5(2): 109-115.
https://doi.org/10.33696/cardiology.5.063
16. Van der Bijl P, Abou R, Goedemans L, Gersh BJ, Holmes Jr DR, Ajmone Marsan N, et al. Left ventricular post-infarct remodeling: implications for systolic function improvement and outcomes in the modern era. Heart Failure 2020; 8(2): 131-140. https://www.jacc.org/doi/abs/10.1016/j.jchf.2019.08.014
17. Wohlfahrt P, Jenča D, Melenovský V, Šramko M, Kotrč M, Želízko M, et al. Trajectories and determinants of left ventricular ejection fraction after the first myocardial infarction in the current era of primary coronary interventions. Front Cardiovasc Med 2022; 9(9): 1-8.
https://doi.org/10.3389/fcvm.2022.1051995
18. Abdelhafez MA, Aly KME, Youssef AAA. Effect of residual myocardial ischemia on recovery of left ventricular function after primary percutaneous coronary intervention. BMC Cardiovasc Dis 2024; 24(1): 164.
https://doi.org/10.1186/s12872-024-03777-3
19. Ramamirtham V, Subramoniam T, Venkatachalam T, Immaneni S. Predictors of Improved Left Ventricular Function After Primary PCI Following STEMI. Iranian Heart J 2022; 23(4): 69-79.
https://journal.iha.org.ir/article_158148_c451844922b8f1d91bf5322292b58598.pdf
20. Perera D, Ryan M, Morgan HP, Greenwood JP, Petrie MC, Dodd M, et al. Viability and outcomes with revascularization or medical therapy in ischemic ventricular dysfunction: a prespecified secondary analysis of the REVIVED-BCIS2 trial. JAMA Cardiol 2023; 8(12): 1154-1161.
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Copyright (c) 2025 Syed Jalal ud Din, Sajjad Ahmad, Adeel Arif, Saim Ali Cheema, Fahim Ahmad Danish, Muhammad Taha
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