Prognostic Value of Area Flow Index in Patients with Acute st Elevation Myocardial Infarction: Clinical and Echocardiographic Outcomes
|Sherif W Ayad*, Mohamed A Sobhy and Mohamed Asadaka|
|Department of Cardiology, Faculty of Medicine, Alexandria University, Egypt|
|*Corresponding Author :||Sherif W Ayad
Department of Cardiology, Faculty of Medicine
Alexandria University, Egypt
Tel: +61 74 9232008
E-mail: [email protected]
|Received: January 02, 2016 Accepted: February 17, 2016 Published: February 23, 2016|
|Citation: Ayad SW, Sobhy MA, Asadaka M (2016) Prognostic Value of Area Flow Index in Patients with Acute st Elevation Myocardial Infarction: Clinical and Echocardiographic Outcomes. Pigmentary Disorders 3:236. doi:10.4172/2376-0427.1000236|
|Copyright: © 2016 Ayad SW, et al. This is an open-acess article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Background: Early restoration of patency of infarct related artery is a universally accepted goal in the treatment of acute myocardial infarction. These could be achieved by Primary PCI or fibrinolysis. Primary PCI is preferred reperfusion strategy over fibrinolysis. Identifying initial area at risk in patients with acute myocardial infarction had been shown to have a direct impact on patients adverse clinical outcomes as well as prediction of systolic dysfunction. Area flow index (AFI) calculation in patients with acute myocardial infarction may predict initial area at risk during primary PCI.
Aim: To investigate the clinical utility of Area flow index to predict systolic dysfunction and adverse clinical outcomes in patients with acute anterior ST elevation myocardial infarction Patients: 250 consecutive patients with acute anterior ST elevation myocardial infarction treated with primary PCI presenting to Alexandria main university hospital and ICC hospital from June 2013 till December 2014. Methods: Echocardiographic assessment of LV systolic function 5-7 days after myocardial infarction by calculation of ejection fraction using modified simpson method. Area flow index was calculated by dividing culprit segment cross sectional area to total coronary cross sectional area. Where DC is the culprit segment diameter, D1 left anterior descending diameter, D2 left circumflex diameter, D3 right coronary diameter. All patients were followed one month for the occurrence of MACE. Results: Patients were grouped according to their ejection fraction following myocardial infarction into 3 groups: -Group I: severe LV systolic dysfunction EF <30%. -Group II: moderate LV systolic dysfunction EF 30-45%. -Group III: mild LV systolic dysfunction EF>45% There was a significant negative correlation between AFI and LVEF (r=-0. 58, P<0. 001). The mean AFI for patients in group I was 33. 1 ± 7.4, patients in group II was 26. 6 ± 7.4, and those in group III was 20.0 ± 6. 1. AFI>28.4% had a 75.6% sensitivity and 78.1% specificity in predicting severe LV systolic dysfunction. Also the composite one month MACE was higher in the group with AFI>28.4% (p<0. 001).
Conclusion: Area flow index calculated from coronary angiography at time of primary PCI is a new strong independent predictor of LV systolic dysfunction and 1month MACE in patients with acute anterior myocardial infarction.