Observational Study of Left Ventricular Global Longitudinal Strain in ST-Segment Elevation Myocardial Infarction Patients with Extended Pharmaco-Invasive Strategy: A Six Months Follow-Up Study

AIMS AND OBJECTIVES:

To evaluate left ventricular (LV) function by assessment of LV global longitudinal strain (GLS) in ST-segment elevation myocardial infarction (STEMI) patients who underwent delayed fibrinolysis and coronary intervention (extended pharmaco-invasive strategy), since LV function is one of the determinants of both immediate and long-term outcomes.

METHODS:

Prospective study of consecutive STEMI patients who underwent extended pharmaco-invasive strategy. The LV function was estimated using LV GLS at baseline and at 6 months.

RESULTS:

The study included eighty-seven STEMI patients who received delayed pharmaco-invasive therapy and coronary intervention. The primary aim of the study was to evaluate a change in LV function by assessment of GLS at 6 months as compared to baseline. Prior to PCI, LV ejection fraction was 48.08 ± 6.23% and GLS was -11.11 ± 2.99%. Procedural success was achieved in all patients. LV ejection fraction after 6 months of follow-up increased to 53.12 ± 5.61% and the GLS improved to -13.03 ± 3.06% In comparison to baseline, there was a significant improvement in both LV ejection fraction and GLS at 6 months of follow-up (P < .001).The cardiac mortality was 1.1% at 6 months.

CONCLUSION:

There is a significant improvement of LV function as assessed by GLS and ejection fraction at short-term follow-up. In a stable cohort of STEMI patients, extended pharmaco-invasive strategy is also a reasonable option if PCI cannot be performed within the first 24 hours, due to logistic and infrastructural constraints.