Predictive Value of Improved and Non-Improved LV Global Longitudinal Strain in Revascularized Acute Myocardial Infarction Patients

Abstract

Background: Echocardiographic measures predict adverse outcomes in cardiac disease patients including prior ST-segment elevation myocardial infarction (STEMI). Aim: To assess the association between improved and non-improved global longitudinal strain (GLS) after three months of percutaneous coronary intervention (PCI)-treated acute myocardial infarction (AMI) and clinical outcomes over one year. Patients and methods: A prospective observational study was conducted at Damietta Cardiology Center (Jan 2022 – June 2023) on 100 patients (44–73 years). They were divided into Group A (improved GLS after revascularized AMI) and Group B (non-improved GLS) Results: GLS improvement, anterior STEMI, baseline Ejection Fraction (EF%) versus EF% after 3 months, baseline E/e ratio versus E/e ratio after 3 months, maximum Troponin T level, symptoms-to-needle time, and number of implanted stents are statistically significant predictors of Cardiovascular and Cerebrovascular Events (CCVE) occurrence (P<0.05), with an overall prediction accuracy of 92%. However, age, sex, and medical history are not statistically significant predictors of CCVE occurrence (P>0.05). Baseline (GLS) and GLS after 3 months are statistically significant predictors of CCVE occurrence (P=0.001), with cutoff points of -7.5 and -13.0, respectively. The sensitivity and specificity for predicting CCVE occurrence are 98.4% and 86.0% for baseline GLS, and 100.0% for both sensitivity and specificity for GLS after 3 months. Conclusion: GLS proved superior to LVEF in predicting CCVE in revascularized AMI, with baseline (-7.5) and 3-month GLS (-13) as key predictors. Improvement correlated with age, prior MI, and inferior STEMI, while non-improvement linked to anterior STEMI.