Predictive Implication of Initial Electrocardiogram and Creatine Kinase for Left Ventricular Ejection Fraction in Patients with Acute ST-Elevation Myocardial Infarction

Aim: Our aim was to determine the clinical, electrocardiographic (ECG) and biochemical predictors of left ventricular dysfunction in patients with acute ST elevation myocardial infarction (STEMI).

Methods: Patients with STEMI admitted in Loghman Hakim hospital were studied. The ECG variables were: ECG rate, ECG rhythm, QRS duration, sum of absolute ST deviation (in all, inferior and anterior leads), number of leads with ST elevation, maximum ST elevation, presence of pathological Q waves and location of the infarct. The primary outcome measure was LVEF ≤ 40%.

Results: A total of 124 patients (91 male, 33 female) were studied. Mean age of the patients was 59.1 years (SD=12.6). Of these, 52 patients (44.4%) had an LVEF ≤ 40% and angiography was recommended to 68 patients (54.8%) at the time of discharge. The multivariate analysis showed an association of LVEF ≤ 40% with prior MI, diabetes, maximum creatine kinase (CK) levels, the sum of absolute ST deviation in all and inferior leads.

Conclusions: The initial ECG and CK levels in patients with STEMI may contain valuable information for risk stratification, determination of prognosis and the subsequent management plan. The results of this study warrant further studies to define patients who benefit most from invasive and sophisticated interventions.

Author(s):

Saeed Nourian, Mohammad Reza Beyranvand, Zeinedin Kheiry, Ali Ali Asgari and Mohamad Asadpour Piranfar

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