Evaluation of Ejection Fraction in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Percutaneous coronary intervention (PCI) is a reperfusion strategy to increase survival and ejection fraction in patients with ST-elevation myocardial infarction (STEMI). Therefore, the aim of the present study was to determine and evaluate the ejection fraction in patients with acute myocardial infarction undergoing percutaneous coronary intervention.

This is a cross-sectional descriptive study that was conducted on 176 patients in Golestan and Imam Khomeini hospitals in Ahvaz in 2022. Patients who underwent angioplasty in the first 12 hours (without receiving fibrinolytic drug) and patients who underwent angioplasty within 12-24 hours after referral (after receiving fibrinolytic drug), 40 days after treatment, all Patients were reevaluated. Patients were compared based on the type of lesion, the number of involved vessels, the type of involved vessel and the location of the lesion in terms of the increase in ejection fraction. Descriptive statistics were used to present quantitative data in the form of mean ± standard deviation and for qualitative variables in the form of percentages, tables and graphs. Chi-square test was used to compare frequency in two groups. T-test was used to compare the mean in two groups. Odds ratio was calculated to compare two groups of case and control in terms of the frequency of each genotype. The collected data were analyzed using Chi-square and t-test.

The most frequent type of lesion diagnosed in patients was type B (61.4%) and the most common vessel involved in patients was the left anterior descending coronary artery (60.2%). The most frequent area involved in the studied patients was diagnosed as anterior (56.8%). There was no significant difference in the increase of jump fraction between the two groups (p=0.2). A marked difference was seen between the ejection fraction, 40 days after treatment based on the involved area (p<0.001), so that at the beginning of the heart attack and before angioplasty, the highest and lowest amount of ejection fraction was observed in patients with involvement, respectively. It was in the posterior region (46.2±5.9) and anterior region (32.2±6.4), after angioplasty regardless of the time, the increase in the second ejection fraction (40 days after myocardial infarction) in patients with obstruction The anterior artery was observed. Correspondingly, the highest rate of ejection fraction was seen in patients with involvement of the right coronary artery (45.7±7) and the lowest amount of ejection fraction was seen in the involvement of the left anterior descending coronary artery (32.4±6.4) (p<0.001). No difference was seen between patients in terms of lesion type (p=0.2). The number of involved vessels had no effect on EF level after treatment (p=0.9) and no significant relationship was observed between the effect of risk factors and EF level (p<0.05).

Based on the results of the present study, the left anterior descending coronary artery and the anterior region were the most involved areas in ST-segment elevation myocardial infarction patients, which led to a further decrease in the ejection fraction. Furthermore, after angioplasty, a greater increase in the second ejection fraction was observed (40 days after a heart attack).