Karatas Mesut, Sabanoglu Cengiz, Sahin Kader Eliz, Inanc Ibrahim Halil
Department of Cardiology, Kosuyolu High Specialization Education and Research Hospital, Istanbul 34865, Turkey.
Department of Cardiology, Umraniye Education and Research Hospital, Istanbul 34760, Turkey.
Medicina (Kaunas). 2025 Mar 11;61(3):487. doi: 10.3390/medicina61030487.
: The prognostic value of Left Ventricular Global Function Index (LVGFI) in chronic cardiovascular diseases is well-documented; however, limited evidence exists for its utility in non-ST elevation myocardial infarction (NSTEMI). This study aims to evaluate LVGFI as a predictor of three-year mortality and major adverse cardiovascular events (MACE) in NSTEMI patients. : This retrospective cohort study included 432 NSTEMI patients divided into tertiles based on LVGFI values: T1 (low), T2 (intermediate), and T3 (high). LVGFI values were derived from echocardiographic imaging. Kaplan-Meier survival analysis was used to assess outcomes, and the Cox proportional hazards models, adjusted for demographics and clinical covariates, determined the association between LVGFI tertiles and three-year outcomes. : The average age and sex distribution were similar across tertiles with no significant differences in cardiovascular risk factors or most laboratory parameters. However, significant differences were noted in body surface area (higher in T3), platelet counts (higher in T1), and triglyceride levels (lower in T3). The ROC analysis identified an optimal LVGFI cut-off of 23.22 for predicting three-year mortality, with a sensitivity of 72% and specificity of 75% (AUC: 0.81; 95% CI: 0.74-0.87, < 0.001). Patients in the T1 exhibited a three-year mortality rate of 25%, compared to 2.1% in the T3. After adjustment, the hazard ratio (HR) for mortality was significantly higher in T1 (HR 11.86; 95% CI: 3.60-39.10) compared to T3. Similarly, MACE rates were highest in T1 (27.1%) and lowest in T3 (7.6%). : LVGFI is a significant independent predictor of three-year mortality and MACE in NSTEMI patients.
左心室整体功能指数（LVGFI）在慢性心血管疾病中的预后价值已有充分文献记载；然而，其在非ST段抬高型心肌梗死（NSTEMI）中的应用证据有限。本研究旨在评估LVGFI作为NSTEMI患者三年死亡率和主要不良心血管事件（MACE）预测指标的价值。
这项回顾性队列研究纳入了432例NSTEMI患者，根据LVGFI值分为三个三分位数组：T1（低）、T2（中）和T3（高）。LVGFI值来自超声心动图成像。采用Kaplan-Meier生存分析评估预后，Cox比例风险模型在对人口统计学和临床协变量进行调整后，确定LVGFI三分位数组与三年预后之间的关联。
各三分位数组的平均年龄和性别分布相似，心血管危险因素或大多数实验室参数无显著差异。然而，在体表面积（T3组较高）、血小板计数（T1组较高）和甘油三酯水平（T3组较低）方面存在显著差异。ROC分析确定预测三年死亡率的最佳LVGFI临界值为23.22，敏感性为72%，特异性为75%（AUC：0.81；95%CI：0.74 - 0.87，P < 0.001）。T1组患者的三年死亡率为25%，而T3组为2.1%。调整后，T1组的死亡风险比（HR）显著高于T3组（HR 11.86；95%CI：3.60 - 39.10）。同样，MACE发生率在T1组最高（27.1%），在T3组最低（7.6%）。
LVGFI是NSTEMI患者三年死亡率和MACE的重要独立预测指标。
