[PP.18.04] PROGRESSION OF LEFT VENTRICULAR HYPERTROPHY AFTER ST-ELEVATION MYOCARDIAL INFARCTION PREDICTS THE RECURRENCE OF MYOCARDIAL INFARCTION

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Abstract

Objective:

Left ventricular hypertrophy (LVH) had been associated with increased adverse cardiovascular events. Prognostic significance of progression LVH in patients with ST-elevation myocardial infarction (STEMI) is uncertain. This study aimed to investigate prognostic impact of progression of LV mass in patients with STEMI.

Design and method:

We analyzed the data and clinical outcomes of patients with STEMI who received successful coronary intervention from 2003 to 2009. We finally enrolled 155 patients (133 males, 56 ± 11 year-old) performed echocardiographic follow-up (F/U) between 12 and 36 months. According to the change in left ventricular mass index (LVMI) compared with baseline LVMI, patients were classified into progression group and non-progression group. Progression of LVMI was defined as increment of LMVI greater than 10% compared with the baseline LVMI. Occurrence of major adverse cardiovascular events (MACE; death, recurrent MI, target vessel revascularization (TVR) within 5 years was evaluated.

Results:

Progression of LVMI was occurred in 41 patients (31 males, 57 ± 12 year-old). Baseline LVMI was significantly smaller in progression group than in non-progression group (97.1 ± 22.5 vs. 121.5 ± 60.4 g/m2, p < 0.001). Mean changes of LVMI in both groups were 28 ± 14% and −12 ± 15 %, respectively. Occurrence of MACE, death and TVR was similar (27 vs. 20 %, 7 vs.9 %, 15 vs. 11 %, respectively) between both groups. Rate of recurrent MI was significantly higher in progression group than in non-progression group (15 vs. 3 %, p = 0.011). By multivariate logistic regression, initial LVMI (odds ratio [OR], 1.012; 95% confidence interval [CI], 1.000–1.023; p = 0.047] and F/U LVMI (OR, 1.016; 95%CI, 1.000–1.032, p = 0.049) were independent predictors for MACE. Progression of LVMI was only independent predictor of recurrent MI (OR, 6.069; 95% CI, 1.426–25.822, p = 0.015).

Conclusions:

In present study, progression of LVMI was an independent predictor for adverse events, especially for recurrent MI, in patients with STEMI who received successful coronary intervention.

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