The predictive value of relative wall thickness on the prognosis of the patients with ST-segment elevation myocardial infarction

Abstract

Objective: The study aimed to evaluate the prognostic value of relative wall thickness (RWT) in the patients with ST-segment elevation myocardial infarction (STEMI).

Methods: A total of 866 patients with STEMI admitted in Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from November 2010 to December 2018 were enrolled in the current study retrospectively. Three methods were used to calculate RWT: RWT_PW, RWT_IVS+PW and RWT_IVS. The included patients were divided according to the median values of RWT_PW, RWT_IVS+PW, and RWT_IVS, respectively. Survival analysis were performed with Kaplan-Meier plot and multivariate Cox proportional hazard model was established to evaluate the adjusted hazard ratio of the three kinds of RWT for all cause death, cardiac death and MACE (major adverse cardiac death).

Results: There was no significance for the survival analysis between the low and high groups of RWT_PW, RWT_IVS+PW and RWT_IVS at 30 days and 12 months. Nonetheless, the cumulative incidence of all cause death and cardiac death in the low group of RWT_PW and RWT_IVS+PW was higher than those in the high group at 60 months. The cumulative incidence of MACE in the low group of RWT_PW was higher than the high group at 60 months. Multivariate Cox regression model showed that RWT_PW were inversely associated with long-term cardiac death and MACE in STEMI patients. In the subgroup analysis, three calculations of RWT had no predictive value for the patients with anterior myocardial infarction. By contrast, RWT_PW was the most stable independent predictor for the long-term outcomes of the patients with non-anterior myocardial infarction.

Conclusion: RWT_PW, RWT_IVS+PW and RWT_IVS had no predictive value for the long-term clinical outcomes of patients with anterior myocardial infarction, whereas RWT_PW was a reliable predictor for all cause death, cardiac death and MACE in patients with non-anterior myocardial infarction.

Keywords: Echocardiography; Primary percutaneous coronary intervention; Prognosis; Relative wall thickness; ST-segment elevation myocardial infarction.