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The possible predictors of the re-hospitalization after STEMI

Session Moderated Poster 1: Interventional cardiology

Speaker Assistant Professor Gordana Krljanac

Congress : Acute Cardiovascular Care 2019

  • Topic : imaging
  • Sub-topic : Echocardiography
  • Session type : Moderated Posters
  • FP Number : 38

Authors : G Krljanac (Belgrade,RS), D Trifunovic (Belgrade,RS), M Asanin (Belgrade,RS), L Savic (Belgrade,RS), V Vukcevic (Belgrade,RS), G Stankovic (Belgrade,RS), M Srdic (Belgrade,RS), L Cucic (Belgrade,RS), J Dudic (Belgrade,RS), I Mrdovic (Belgrade,RS)

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Authors:
G Krljanac1 , D Trifunovic1 , M Asanin1 , L Savic1 , V Vukcevic1 , G Stankovic1 , M Srdic2 , L Cucic3 , J Dudic3 , I Mrdovic1 , 1Clinical Centre of Serbia, Cardiology Clinic, Medical Faculty - Belgrade - Serbia , 2Clinical center of Serbia, Cardiology Clinic - Belgrade - Serbia , 3Medical Faculty - Belgrade - Serbia ,

Citation:

Aim: to define whether quantification of myocardial mechanics early after pPCI using modern echocardiography offers information more to predict the re-hospitalizations (due to re-infarction, severe angina pectoris, heart failure and malignant arrhythmia) during the first year after pPCI. 
Methods: In the 157 consecutive STEMI patients (pts) in PREDICT-VT study (NCT03263949) treated with pPCI was done early echo (5±2 days) including conventional parameters and comprehensive speckle tracking LV deformation analysis with longitudinal (L), and circumferential (C) strain (S;%) on three layers (endo, mid and epi). ROC analysis was performed to identify the best parameters to predict re-hospitalization.
Results: 11.4% pts re-hospitalized after discharged: 2 due to re-infarction, 5 for heart failure, 4 for unstable angina and 7 for new onset arrhythmia. Re-hospitalized pts were at similar age (59.2±11.1 vs. 56.9±10.1, p=NS), insignificantly more had diabetes (27.8% vs. 24.5%), hypertension (72.2% vs. 67.8%), hyperlipidaemia (50.% vs. 56.6%) and other comorbidities. Peak systolic LS on mid and endo layers were significantly lower, as well as peak systolic CS on each layers in re-hospitalized pts (table). The peak systolic CS on endo layer had the largest area under the ROC (0.697, p=0.011, 95% CI 0.566-0.828) (-18.1%, sens 70.1% and spec 68.6%). Conclusion: Peak systolic LS and peak systolic CS could be used for early stratification of STEMI patients treated by pPCI for re-hospitalization prediction during the first year.

Re-hospitalized pts

Non-re-hospitalized pts

p

Peak Syst LS epi (%)

-9.5±3.2

-11.5±3.9

0.064

Peak Syst LS mid (%)

-10.2±4.5

-12.7±5.4

0.047

Peak Syst LS end (%)

-12.2±5.0

-15.4±4.5

0.030

Peak Syst CS epi (%)

-8.1±2.9

-10.4±3.7

0.015

Peak Syst CS mid (%)

-11.3±4.0

-14.6±4.8

0.011

Peak Syst CS end (%)

-16.3±5.9

-20.9±6.7

0.009



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