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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
Author(s) -
Manjunath Satvic C.,
Doddaiah Balaraju,
Ananthakrishna Rajiv,
Sastry Sridhar Lakshmana,
Patil Vikram S.,
Devegowda Lachikrathman,
Veervhadraiah Sumangala B.,
bhat Prabhavathi,
Nanjappa Manjunath Cholenahally
Publication year - 2020
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14588
Subject(s) - medicine , ejection fraction , cardiology , conventional pci , myocardial infarction , percutaneous coronary intervention , fibrinolysis , heart failure
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.