Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Indian Heart J. 2022 Sep-Oct;74(5):369-374. doi: 10.1016/j.ihj.2022.08.002. Epub 2022 Aug 14.
This study aimed to evaluate the long-term prognostic value of E/e' ratio in patients with ST-segment elevation myocardial infarction (STEMI).
We retrospectively assessed 314 patients who underwent primary coronary interventions between January 2010 and December 2015. The included patients were classified into two groups according to the E/e' ratios: E/e'<15 (n = 245) and E/e'≥15 (n = 69). We investigated the incidence of major adverse cardiac events (MACEs) from the event to the final follow-up period of at least three years.
A total of 55 cases of MACEs occurred during the follow-up. The E/e'≥15 group showed a significantly higher rate of MACEs than the E/e'<15 group (34.8% vs. 12.7%, p < 0.001). Among the MACE, the percentage of cardiac deaths (17.4% vs. 0.4%, p < 0.001) was higher in the E/e'≥15 group than in the E/e'<15 group. In the multivariable model, E/e'≥15 was demonstrated as the strongest prognostic factor for MACEs (hazard ratio [HR], 2.597; 95% confidence interval [CI], 1.294-5.211; p = 0.007) and cardiac death (HR, 27.537; 95% CI, 3.287-230.689; p = 0.002), while left ventricular ejection fraction (LVEF) was not. Neither the discrepancy of systolic nor diastolic function between initial and follow-up echocardiography affected the overall prevalence of MACEs. A disparity was observed between the two groups, with a significant increase in the rate of MACEs in the E/e'≥15 group (log-rank test, p < 0.001).
The baseline E/e'≥15 in patients with STEMI after successful reperfusion is the strongest predictor of poor long-term clinical outcomes among those analyzed.
本研究旨在评估 E/e' 比值对 ST 段抬高型心肌梗死（STEMI）患者的长期预后价值。
我们回顾性评估了 2010 年 1 月至 2015 年 12 月期间接受直接冠状动脉介入治疗的 314 例患者。根据 E/e' 比值将纳入的患者分为两组：E/e'<15（n=245）和 E/e'≥15（n=69）。我们从事件到至少 3 年的最终随访期间，调查了主要不良心脏事件（MACEs）的发生率。
在随访期间共发生 55 例 MACEs。E/e'≥15 组的 MACEs 发生率明显高于 E/e'<15 组（34.8%比 12.7%，p<0.001）。在 MACE 中，E/e'≥15 组的心脏死亡百分比（17.4%比 0.4%，p<0.001）高于 E/e'<15 组。在多变量模型中，E/e'≥15 是 MACEs 的最强预后因素（危险比[HR]，2.597；95%置信区间[CI]，1.294-5.211；p=0.007）和心脏死亡（HR，27.537；95%CI，3.287-230.689；p=0.002），而左心室射血分数（LVEF）不是。初始和随访超声心动图之间收缩和舒张功能差异既不会影响 MACEs 的总体发生率，也不会影响 MACEs 的总体发生率。两组之间存在差异，E/e'≥15 组的 MACEs 发生率显著增加（对数秩检验，p<0.001）。
成功再灌注后 STEMI 患者的基线 E/e'≥15 是分析人群中不良长期临床结局的最强预测因子。
