The Prognostic Value of Echocardiographic Wall Motion Score Index in ST-Segment Elevation Myocardial Infarction
Background. When compared to left ventricular ejection fraction (LVEF), previous studies have suggested the superiority of wall motion score index (WMSI) in predicting cardiac events in patients who have suffered acute myocardial infarction. However, there are limited studies assessing WMSI and mort...
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| Format: | Article |
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Wiley
2022-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2022/8343785 |
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| author | Michael L. Savage Karen Hay Bonita Anderson Gregory Scalia Darryl Burstow Dale Murdoch Isuru Ranasinghe Owen Christopher Raffel |
| author_facet | Michael L. Savage Karen Hay Bonita Anderson Gregory Scalia Darryl Burstow Dale Murdoch Isuru Ranasinghe Owen Christopher Raffel |
| author_sort | Michael L. Savage |
| collection | DOAJ |
| description | Background. When compared to left ventricular ejection fraction (LVEF), previous studies have suggested the superiority of wall motion score index (WMSI) in predicting cardiac events in patients who have suffered acute myocardial infarction. However, there are limited studies assessing WMSI and mortality in ST-segment elevation myocardial infarction (STEMI). We aimed to compare the prognostic value of WMSI in a cohort of STEMI patients treated with primary percutaneous coronary intervention (PCI). Methods. A comparison of WMSI, LVEF, and all-cause mortality in STEMI patients treated with primary PCI between January 2008 and December 2020 was performed. The prognostic value of WMSI, LVEF, and traditional risk scores (TIMI, GRACE) were compared using multivariable logistic regression modelling. Results. Among 1181 patients, 27 died within 30-days (2.3%) and 49 died within 12 months (4.2%). WMSI ≥1.8 was associated with poorer survival at 12-months (9.2% vs 1.5%; p<0.001). When used as the only classifier for predicting 12-month mortality, the discriminatory ability of WMSI (area under the curve (AUC): 0.77; 95% CI: 0.68–0.84) was significantly better than LVEF (AUC: 0.71; 95% CI: 0.61–0.79; p=0.034). After multivariable modelling, the AUC was comparable between models with either WMSI (AUC: 0.89; 95% CI: 0.85–0.94) or LVEF (AUC: 0.87; 95% CI: 0.83–0.92; p<0.08) yet performed significantly better than TIMI (AUC: 0.71; 95% CI: 0.62–0.79; p<0.001), or GRACE (AUC: 0.63; 95% CI: 0.54–0.71; p<0.001) risk scores. Conclusions. When examined individually, WMSI is a superior predictor of 12-month mortality over LVEF in STEMI patients treated with primary PCI. When examined in multivariable predictive models, WMSI and LVEF perform very well at predicting 12-month mortality, especially when compared to existing STEMI risk scores. |
| format | Article |
| id | doaj-art-ec1af620a5564c608e5c586080c45fa5 |
| institution | Kabale University |
| issn | 2090-1313 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
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| series | Critical Care Research and Practice |
| spelling | doaj-art-ec1af620a5564c608e5c586080c45fa52025-02-03T05:57:29ZengWileyCritical Care Research and Practice2090-13132022-01-01202210.1155/2022/8343785The Prognostic Value of Echocardiographic Wall Motion Score Index in ST-Segment Elevation Myocardial InfarctionMichael L. Savage0Karen Hay1Bonita Anderson2Gregory Scalia3Darryl Burstow4Dale Murdoch5Isuru Ranasinghe6Owen Christopher Raffel7Cardiology DepartmentCardiology DepartmentCardiology DepartmentCardiology DepartmentCardiology DepartmentCardiology DepartmentCardiology DepartmentCardiology DepartmentBackground. When compared to left ventricular ejection fraction (LVEF), previous studies have suggested the superiority of wall motion score index (WMSI) in predicting cardiac events in patients who have suffered acute myocardial infarction. However, there are limited studies assessing WMSI and mortality in ST-segment elevation myocardial infarction (STEMI). We aimed to compare the prognostic value of WMSI in a cohort of STEMI patients treated with primary percutaneous coronary intervention (PCI). Methods. A comparison of WMSI, LVEF, and all-cause mortality in STEMI patients treated with primary PCI between January 2008 and December 2020 was performed. The prognostic value of WMSI, LVEF, and traditional risk scores (TIMI, GRACE) were compared using multivariable logistic regression modelling. Results. Among 1181 patients, 27 died within 30-days (2.3%) and 49 died within 12 months (4.2%). WMSI ≥1.8 was associated with poorer survival at 12-months (9.2% vs 1.5%; p<0.001). When used as the only classifier for predicting 12-month mortality, the discriminatory ability of WMSI (area under the curve (AUC): 0.77; 95% CI: 0.68–0.84) was significantly better than LVEF (AUC: 0.71; 95% CI: 0.61–0.79; p=0.034). After multivariable modelling, the AUC was comparable between models with either WMSI (AUC: 0.89; 95% CI: 0.85–0.94) or LVEF (AUC: 0.87; 95% CI: 0.83–0.92; p<0.08) yet performed significantly better than TIMI (AUC: 0.71; 95% CI: 0.62–0.79; p<0.001), or GRACE (AUC: 0.63; 95% CI: 0.54–0.71; p<0.001) risk scores. Conclusions. When examined individually, WMSI is a superior predictor of 12-month mortality over LVEF in STEMI patients treated with primary PCI. When examined in multivariable predictive models, WMSI and LVEF perform very well at predicting 12-month mortality, especially when compared to existing STEMI risk scores.http://dx.doi.org/10.1155/2022/8343785 |
| spellingShingle | Michael L. Savage Karen Hay Bonita Anderson Gregory Scalia Darryl Burstow Dale Murdoch Isuru Ranasinghe Owen Christopher Raffel The Prognostic Value of Echocardiographic Wall Motion Score Index in ST-Segment Elevation Myocardial Infarction Critical Care Research and Practice |
| title | The Prognostic Value of Echocardiographic Wall Motion Score Index in ST-Segment Elevation Myocardial Infarction |
| title_full | The Prognostic Value of Echocardiographic Wall Motion Score Index in ST-Segment Elevation Myocardial Infarction |
| title_fullStr | The Prognostic Value of Echocardiographic Wall Motion Score Index in ST-Segment Elevation Myocardial Infarction |
| title_full_unstemmed | The Prognostic Value of Echocardiographic Wall Motion Score Index in ST-Segment Elevation Myocardial Infarction |
| title_short | The Prognostic Value of Echocardiographic Wall Motion Score Index in ST-Segment Elevation Myocardial Infarction |
| title_sort | prognostic value of echocardiographic wall motion score index in st segment elevation myocardial infarction |
| url | http://dx.doi.org/10.1155/2022/8343785 |
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