Authors

• Zdravko Babić — School of Medicine, Zagreb, Croatia — ORCID: 0000-0002-7060-8375
• Marko Mornar Jelavić — Polyclinic Medikol, Zagreb, Croatia — ORCID: 0000-0002-9135-1820
• Dorijan Babić — School of Medicine, Zagreb, Croatia
• Diana Balenović — General Hospital dr. Ivo Pedišić, Sisak, Croatia — ORCID: 0000-0001-8182-6848
• Ronald Lipovščak — General Hospital Karlovac, Karlovac, Croatia — ORCID: 0000-0001-6658-0931
• Hrvoje Pintarić — Sestre Milosrdnice University Hospital Center, Zagreb, Croatia — ORCID: 0000-0002-7741-4194

Keywords

acute ST-elevation myocardial infarction, primary percutaneous coronary intervention, long-term prognosis

DOI

Full Text

**Goal**: to investigate the long-term prognosis of acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). **Patients and Methods**: This prospective study included 229 patients who survived acute STEMI. They were followed (2011-2021) and classified into two groups (with/without major adverse cardiovascular events (MACE)), and compared by their baseline (age, gender, cardiovascular risk factors), laboratory (maximal CK/TnT, acute inflammatory (white blood cells (WBC), hs-CRP) and liver biomarkers (AST/LDH), glomerular filtration rate (eGFR)), angiographic (stenosed coronary arteries and their segments, Gensini score) and clinical severity parameters (hospitalization duration, total in-hospital complications, echocardiography (LVEF)). **Results**: Cardiac rehospitalization, stroke, mortality and total MACE was present at 35.4%, 3.4%, 4.8% and 38.9% of patients, respectively. Logistic regression analysis revealed that several baseline (age, hypertension, metabolic syndrome, previous PCI/CABG), laboratory (LDH, max CK), angiographic (significant stenosis of LAD and ACx, multivessel CAD, proximal coronary stenosis, Gensini score), and clinical severity parameters (total in-hospital complications) increase, while the others (higher eGFR and LVEF) reduce the risk of the total MACE (for all P<0.05). In the multivariate analysis, the number of significantly stenosed coronary arteries, as well as lower LVEF and eGFR are the main predictors of the total MACE (for all P<0.05). **Conclusion**: Long-term prognosis after acute STEMI is influenced by the severity of the CAD, systolic and kidney function. (1-3) Primary prevention must be directed to the treatment of arterial hypertension and metabolic syndrome generally, two modifable risk factors that increase the risk of MACE.

Literature

1. Klancik V, Pesl L, Neuberg M, Tousek P, Kocka V. Long-term follow-up in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention. Eur Heart J Suppl. 2022 March 30;24 Suppl B:B16–22. https://doi.org/10.1093/eurheartjsupp/suac003
2. Mornar Jelavic M, Babic Z, Pintaric H. Metabolic syndrome: influence on clinical severity and prognosis in patients with acute ST-elevation myocardial infarction treated with primary percutaneous coronary intervention. Acta Cardiol. 2015 April;70(2):149–56. https://doi.org/10.1080/AC.70.2.3073505
3. Mornar Jelavić M, Babić Z, Pintarić H, Mišigoj-Duraković M. The Role of Anthropometry in Acute St-Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention. Acta Clin Croat. 2016 June;55(2):224–32. https://doi.org/10.20471/acc.2016.55.02.07