Left ventricular hypertrophy on long-term cardiovascular outcomes in patients with ST-elevation myocardial infarction

• Published in: Clinical and experimental hypertension (1993) 2015-11, Vol.37 (8), p.674-679
• Main Authors: Park, Jin-Sun, Shin, Jeong-Sook, Lee, You-Hong, Seo, Kyoung-Woo, Choi, Byoung-Joo, Choi, So-Yeon, Yoon, Myeong-Ho, Hwang, Gyo-Seung, Tahk, Seung-Jea, Shin, Joon-Han
• Format: Article
• Language: English
• Subjects: Echocardiography; Electrocardiography; Female; Follow-Up Studies; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Hypertrophy, Left Ventricular - complications; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - mortality; Left ventricular hypertrophy; Male; Middle Aged; myocardial infarction; Myocardial Infarction - complications; Myocardial Infarction - mortality; Myocardial Infarction - physiopathology; Prognosis; Republic of Korea - epidemiology; Survival Rate - trends; Time Factors; Ventricular Function, Left - physiology
• ISSN: 1064-1963; 1525-6006
• DOI: 10.3109/10641963.2015.1047943

Background: Left ventricular hypertrophy (LVH) had been associated with increased adverse cardiovascular events in hypertensive patients. Prognostic significance of LVH in patients with ST-elevation myocardial infarction (STEMI) is not established. This study aimed to investigate prognostic impact of LVH on the patients with STEMI. Methods: We analyzed the data and clinical outcomes of 30-day survivors with STEMI who underwent successful coronary intervention from 2003 to 2009. Definition of LVH was LV mass index (LVMI) >115 g/m 2 in male and >95 g/m 2 in female. Patients were classified into a LVH group and a non-LVH group. Occurrence of major adverse cardiovascular events (MACE; death, recurrent MI, target vessel revascularization (TVR)) within 5 years was evaluated. Results: We enrolled 418 patients and mean follow-up duration was 43 ± 17 months. Two hundred and fourteen patients (51%) had LVH. The survival of the patients with LVH was significantly worse than the patients without LVH (log-rank p = 0.024). In a multivariate regression model, the presence of LVH was independently associated with increased risk for all-cause mortality (OR, 2.37; 95% CI, 1.096-5.123, p = 0.028). When the end points were analyzed based on LVH severity, all-cause mortality was significantly correlated with LVH severity (p = 0.011). The severe LVH was independently associated with increased risk for all-cause mortality (OR, 5.110; 95% CI, 1.454-17.9, p = 0.001). Conclusion: LVH was associated with increased rate of adverse clinical outcomes in 30-day survivors after STEMI, who underwent successful coronary intervention.