Predictive factors of early left ventricular remodeling and reverse remodeling in patients with STEMI after successful reperfusion therapy.

BACKGROUND

Despite successful reperfusion therapy, a subset of patients with ST-segment elevation myocardial infarction (STEMI) experience early left ventricular remodeling (LVR) within 72 h of symptom onset. LVR is associated with poor outcomes, whereas LV reverse remodeling (LVRR) is correlated with favorable prognosis. This study investigated the factors associated with early LVR and LVRR in STEMI patients.

METHODS

We enrolled 233 consecutive STEMI patients who successfully underwent reperfusion therapy within 12 h of symptom onset between April 2022 to January 2024. They were categorized into non-LVR (n = 135) and early LVR (n = 98) groups based on their LV ejection fraction (LVEF). The early LVR group patients were categorized into LVRR (n = 46) and non-LVRR (n = 52) subgroups based on the LVEF values at 5-7 days after symptom onset. Logistic regression models were used to identify the predictive factors associated with early LVR and LVRR.

RESULTS

Multivariate analysis showed that the admission heart rate (HR) (odds ratio [OR] = 2.965, P = 0.005), peak creatine kinase MB (CK-MB) level (OR = 6.166, P < 0.001), fasting plasma glucose (FPG) concentration (OR = 3.608, P = 0.002), and perfusion score index (PSI) (OR = 91.976, P < 0.001) were independent predictive factors for early LVR. Moreover, pericardial effusion (PE) and PSI within 72 h of symptom onset were predictive factors for failure of LVRR.

CONCLUSION

Our data showed that admission HR, CK-MB peak level, FPG concentration, and PSI were independent predictive factors for early LVR, whereas PE and PSI were predictive factors for failure of LVRR in STEMI patients.