PeerJ · 2026
Impact of left ventricular end-diastolic diameter size within 24 hours of hospital admission on outcome events in patients with ST-elevation myocardial infarction.
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Zhang Lingling, Liu Zhican, Zhou Li, Peng Li, Luo Yan, Chen Juan, Zeng Jianping, Zhou Xianghong, Wu Mingxing, Liang Yong, Jiang MingYan
Аннотация
BACKGROUND: The prognosis of patients with ST-elevation myocardial infarction (STEMI) is closely related to the left ventricular end-diastolic diameter (LVEDD) size. However, the associations between LVEDD, pre-admission risk factors, admission biochemical markers, and medication use warrant further investigation. The prognostic impact of LVEDD evaluation within 24 hours of admission in STEMI patients has not been extensively studied.
METHODS: We analyzed the association between LVEDD measurements within 24 hours of admission and a composite endpoint of cardiovascular events and mortality in 664 STEMI patients undergoing percutaneous coronary intervention (PCI). Patients were categorized into three groups based on LVEDD size. Multiple regression models examined the relationship among pre-admission factors, biochemical markers, medication use, and LVEDD.
RESULTS: Composite endpoint events occurred in 249 patients. A larger admission LVEDD was associated with a higher risk of endpoint events (hazard ratio (HR) 1.032; 95% confidence interval (CI) [1.004-1.061]; P = 0.027), especially when LVEDD exceeded 47 mm (HR 1.605, 95% CI [1.185-2.174], P = 0.002) and 54 mm (HR 1.647, 95% CI [1.027-2.643], P = 0.039). Multivariate regression identified independent factors influencing composite endpoint events and LVEDD, including Killip classification ≥2, obesity, use of vasoactive drugs, pre-admission history of cardiomyopathy, NT-proBNP, uric acid, albumin, and the use of spironolactone, diuretics, and digoxin (All P values < 0.05).
CONCLUSION: LVEDD measurement within 24 hours of admission is crucial for predicting composite endpoint events in STEMI patients. An elevated risk is observed in patients with LVEDD greater than 47 mm, which is further amplified when LVEDD surpasses 54 mm. Identifying independent factors influencing LVEDD and clinical outcomes provides valuable insights for clinical management.
METHODS: We analyzed the association between LVEDD measurements within 24 hours of admission and a composite endpoint of cardiovascular events and mortality in 664 STEMI patients undergoing percutaneous coronary intervention (PCI). Patients were categorized into three groups based on LVEDD size. Multiple regression models examined the relationship among pre-admission factors, biochemical markers, medication use, and LVEDD.
RESULTS: Composite endpoint events occurred in 249 patients. A larger admission LVEDD was associated with a higher risk of endpoint events (hazard ratio (HR) 1.032; 95% confidence interval (CI) [1.004-1.061]; P = 0.027), especially when LVEDD exceeded 47 mm (HR 1.605, 95% CI [1.185-2.174], P = 0.002) and 54 mm (HR 1.647, 95% CI [1.027-2.643], P = 0.039). Multivariate regression identified independent factors influencing composite endpoint events and LVEDD, including Killip classification ≥2, obesity, use of vasoactive drugs, pre-admission history of cardiomyopathy, NT-proBNP, uric acid, albumin, and the use of spironolactone, diuretics, and digoxin (All P values < 0.05).
CONCLUSION: LVEDD measurement within 24 hours of admission is crucial for predicting composite endpoint events in STEMI patients. An elevated risk is observed in patients with LVEDD greater than 47 mm, which is further amplified when LVEDD surpasses 54 mm. Identifying independent factors influencing LVEDD and clinical outcomes provides valuable insights for clinical management.