The Possibilities of Predicting Left Ventricular Ejection Fraction 12 Months After ST-Segment Elevation Myocardial Infarction

Aim    To identify predictors and develop a model for prognosis of left ventricular (LV) ejection fraction (EF) 12 months after ST-segment elevation myocardial infarction (STEMI) on electrocardiogram (ECG).
Material and methods    This was a prospective registry study of patients admitted within 24 h of STEMI. Concentrations of soluble suppression of tumorigenicity 2, proprotein convertase subtilisin/kexin type 9, N-terminal pro-B-type natriuretic peptide (NTproBNP), high-sensitivity troponin I (TnI), and C-reactive protein were measured. LVEF was determined using the Simpson method at one, 10-12 days, and 12 months after STEMI. The study included 138 patients; after 12 months, LVEF was determined in 112 patients. The patients were divided into groups based on their LVEF: with preserved EF (pLVEF), LVEF ≥50% (n=51); moderately reduced EF (mrLVFE), LVEF 41-49% (n=40); and reduced EF (rLVEF), LVEF ≤40% (n=11).
Results     A model for predicting LVEF 12 months after STEMI was constructed using the ordinal regression. The model sensitivity was 88.2% for predicting pLVEF, 71.8% for predicting mrLVEF, and 72.5% for predicting rLVEF. The model specificity was 59.1%. The factors determining LVEF in STEMI patients after 12 months included the formation of postinfarction LV aneurysm, LVEF on days 10-12 after STEMI, the magnitude in mm of ST segment elevation on the ECG upon admission, and the TnI concentration on the first day of STEMI.
Conclusions    The obtained model for predicting LVEF 12 months after STEMI allows prognosing LVEF in all its ranges with a sensitivity of more than 70%.

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