Prognostic Significance of Echocardiographic Characteristics in Patients with Type 2 Myocardial Infarction: comparison with Type 1 Myocardial Infarction
Aim. To outline echocardiographic features and assess their prognostic significance for major cardiovascular adverse events (MACEs) within 12 months in patients with type 2 myocardial infarction (MI), compared to type 1 MI (T1MI).Material and methods. The prospective observational study included 161...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Столичная издательская компания
2023-11-01
|
| Series: | Рациональная фармакотерапия в кардиологии |
| Subjects: | |
| Online Access: | https://www.rpcardio.online/jour/article/view/2940 |
| _version_ | 1797232026769686528 |
|---|---|
| author | T. H. Hoang V. V. Maiskov I. A. Merai A. F. Safarova Z. D. Kobalava |
| author_facet | T. H. Hoang V. V. Maiskov I. A. Merai A. F. Safarova Z. D. Kobalava |
| author_sort | T. H. Hoang |
| collection | DOAJ |
| description | Aim. To outline echocardiographic features and assess their prognostic significance for major cardiovascular adverse events (MACEs) within 12 months in patients with type 2 myocardial infarction (MI), compared to type 1 MI (T1MI).Material and methods. The prospective observational study included 161 MI patients who underwent coronary angiography within 24 hours of admission. Type 2 MI (T2MI) diagnosis aligned with the Fourth Universal Definition. Echocardiography and speckle-tracking echocardiography were performed within 72 hours of hospitalization. MACEs encompassed cardiovascular death, non-fatal MI, non-fatal stroke, and HF-related readmissions. Logistic regression analysis was conducted to evaluate their associations with the outcomes.Results. T2MI were diagnosed in 74 patients (median age, 65 years; males, 55,4%). During follow up, 18 patients for each MI type experienced at least one MACE event. Left ventricular (LV) systolic dysfunction (LV ejection fraction [LVEF] <50%) was observed in 41 (55.4%) T2MI patients, compared with 66 (75.9%) T1MI patients (p=0.014). Median LVEF and global longitudinal strain [GLS] were 47.5% and 13.4%, respectively, for T2MI, compared to 45% and 13.9%, respectively, for T1MI (p=0.032 and p=0.332, respectively). LV diastolic dysfunction [DD] was observed in 56 (75.7%) T2MI and 77 (88.5%) T1MI patients. Grade III was more frequent in T2MI in comparison with T1MI (14.9% vs 1.1%, p=0.001, respectively), whereas grade I was more common in T1MI patients (75.9% vs 43.2%, p=0.004, respectively). Right ventricular (RV) dysfunction was observed more frequent in T2MI patients, compared to those with T2MI (52.7% vs. 35.6%, p=0.025, respectively). In univariate analysis, grade III DD was significantly associated with MACEs in T2MI (odds ratio [OR] 5.1, 95% confidence interval [CI], 1.3–18.5, p=0.017). In multivariate analysis, GLS ≤ 9.6% (OR = 17.3, 95% CI 3.0-99.5, p=0.001), and prior MI (OR = 16.6, 95% CI 1.7–157.6, p=0.015) were significantly associated with a heightened risk of MACEs in T2MI patients.Conclusion. Patients with T2MI had high prevalence of LV and RV dysfunction. Echocardiographic assessments, particularly speckle-tracking echocardiography, hold promise in predicting adverse outcomes for these individuals. |
| first_indexed | 2024-03-08T14:00:10Z |
| format | Article |
| id | doaj.art-7a1be62d34424c1cbdf04374572c338b |
| institution | Directory Open Access Journal |
| issn | 1819-6446 2225-3653 |
| language | English |
| last_indexed | 2024-04-24T15:53:44Z |
| publishDate | 2023-11-01 |
| publisher | Столичная издательская компания |
| record_format | Article |
| series | Рациональная фармакотерапия в кардиологии |
| spelling | doaj.art-7a1be62d34424c1cbdf04374572c338b2024-04-01T07:43:43ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532023-11-0119546146910.20996/1819-6446-2023-29402150Prognostic Significance of Echocardiographic Characteristics in Patients with Type 2 Myocardial Infarction: comparison with Type 1 Myocardial InfarctionT. H. Hoang0V. V. Maiskov1I. A. Merai2A. F. Safarova3Z. D. Kobalava4Pham Ngoc Thach University of MedicinePeoples’ Friendship University of Russia; Vinogradov Moscow City Clinical HospitalPeoples’ Friendship University of Russia; Vinogradov Moscow City Clinical HospitalPeoples’ Friendship University of Russia; Vinogradov Moscow City Clinical HospitalPeoples’ Friendship University of RussiaAim. To outline echocardiographic features and assess their prognostic significance for major cardiovascular adverse events (MACEs) within 12 months in patients with type 2 myocardial infarction (MI), compared to type 1 MI (T1MI).Material and methods. The prospective observational study included 161 MI patients who underwent coronary angiography within 24 hours of admission. Type 2 MI (T2MI) diagnosis aligned with the Fourth Universal Definition. Echocardiography and speckle-tracking echocardiography were performed within 72 hours of hospitalization. MACEs encompassed cardiovascular death, non-fatal MI, non-fatal stroke, and HF-related readmissions. Logistic regression analysis was conducted to evaluate their associations with the outcomes.Results. T2MI were diagnosed in 74 patients (median age, 65 years; males, 55,4%). During follow up, 18 patients for each MI type experienced at least one MACE event. Left ventricular (LV) systolic dysfunction (LV ejection fraction [LVEF] <50%) was observed in 41 (55.4%) T2MI patients, compared with 66 (75.9%) T1MI patients (p=0.014). Median LVEF and global longitudinal strain [GLS] were 47.5% and 13.4%, respectively, for T2MI, compared to 45% and 13.9%, respectively, for T1MI (p=0.032 and p=0.332, respectively). LV diastolic dysfunction [DD] was observed in 56 (75.7%) T2MI and 77 (88.5%) T1MI patients. Grade III was more frequent in T2MI in comparison with T1MI (14.9% vs 1.1%, p=0.001, respectively), whereas grade I was more common in T1MI patients (75.9% vs 43.2%, p=0.004, respectively). Right ventricular (RV) dysfunction was observed more frequent in T2MI patients, compared to those with T2MI (52.7% vs. 35.6%, p=0.025, respectively). In univariate analysis, grade III DD was significantly associated with MACEs in T2MI (odds ratio [OR] 5.1, 95% confidence interval [CI], 1.3–18.5, p=0.017). In multivariate analysis, GLS ≤ 9.6% (OR = 17.3, 95% CI 3.0-99.5, p=0.001), and prior MI (OR = 16.6, 95% CI 1.7–157.6, p=0.015) were significantly associated with a heightened risk of MACEs in T2MI patients.Conclusion. Patients with T2MI had high prevalence of LV and RV dysfunction. Echocardiographic assessments, particularly speckle-tracking echocardiography, hold promise in predicting adverse outcomes for these individuals.https://www.rpcardio.online/jour/article/view/2940type 2 myocardial infarctionsystolic functiondiastolic functionglobal longitudinal strain |
| spellingShingle | T. H. Hoang V. V. Maiskov I. A. Merai A. F. Safarova Z. D. Kobalava Prognostic Significance of Echocardiographic Characteristics in Patients with Type 2 Myocardial Infarction: comparison with Type 1 Myocardial Infarction Рациональная фармакотерапия в кардиологии type 2 myocardial infarction systolic function diastolic function global longitudinal strain |
| title | Prognostic Significance of Echocardiographic Characteristics in Patients with Type 2 Myocardial Infarction: comparison with Type 1 Myocardial Infarction |
| title_full | Prognostic Significance of Echocardiographic Characteristics in Patients with Type 2 Myocardial Infarction: comparison with Type 1 Myocardial Infarction |
| title_fullStr | Prognostic Significance of Echocardiographic Characteristics in Patients with Type 2 Myocardial Infarction: comparison with Type 1 Myocardial Infarction |
| title_full_unstemmed | Prognostic Significance of Echocardiographic Characteristics in Patients with Type 2 Myocardial Infarction: comparison with Type 1 Myocardial Infarction |
| title_short | Prognostic Significance of Echocardiographic Characteristics in Patients with Type 2 Myocardial Infarction: comparison with Type 1 Myocardial Infarction |
| title_sort | prognostic significance of echocardiographic characteristics in patients with type 2 myocardial infarction comparison with type 1 myocardial infarction |
| topic | type 2 myocardial infarction systolic function diastolic function global longitudinal strain |
| url | https://www.rpcardio.online/jour/article/view/2940 |
| work_keys_str_mv | AT thhoang prognosticsignificanceofechocardiographiccharacteristicsinpatientswithtype2myocardialinfarctioncomparisonwithtype1myocardialinfarction AT vvmaiskov prognosticsignificanceofechocardiographiccharacteristicsinpatientswithtype2myocardialinfarctioncomparisonwithtype1myocardialinfarction AT iamerai prognosticsignificanceofechocardiographiccharacteristicsinpatientswithtype2myocardialinfarctioncomparisonwithtype1myocardialinfarction AT afsafarova prognosticsignificanceofechocardiographiccharacteristicsinpatientswithtype2myocardialinfarctioncomparisonwithtype1myocardialinfarction AT zdkobalava prognosticsignificanceofechocardiographiccharacteristicsinpatientswithtype2myocardialinfarctioncomparisonwithtype1myocardialinfarction |