Original scientific paper

https://doi.org/10.20471/acc.2024.63.03-04.34

Ten-Year Outcomes after Acute STEMI Treated with Primary PCI – the Role of Acute Biomarkers and Other Parameters in Predicting Clinical Severity and Prognosis

Marko Mornar Jelavić orcid.org/0000-0002-9135-1820 ; Affidea Croatia, Sveti Rok Polyclinic, Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Zagreb, Croatia *
Zdravko Babić ; School of Medicine, University of Zagreb, Zagreb, Croatia; Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia; Coronary Care Unit, Division of Cardiology, Department of Internal Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Dorijan Babić ; School of Medicine, University of Zagreb, Zagreb, Croatia
Diana Balenović ; Department of Cardiology, Dr. Ivo Pedišić General Hospital, Sisak, Croatia
Ronald Lipovšćak ; Department of Cardiology, Karlovac General Hospital, Karlovac, Croatia
Hrvoje Pintarić ; School of Dental Medicine, University of Zagreb, Zagreb, Croatia; Aviva Polyclinic, Zagreb, Croatia; Traumatology Department, Sestre milosrdnice University Hospital Center, Zagreb, Croatia

* Corresponding author.

Abstract

This rare prospective study investigated 10-year outcomes of acute ST-elevation
myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), and
evaluated the role of acute biomarkers and other parameters in predicting clinical severity and prognosis.
We included 250 patients and analyzed their baseline (cardiovascular risk factors), laboratory (maximal
CK/TnT, acute inflammatory (white blood cells (WBC), hs-CRP), and liver biomarkers (AST/LDH),
glomerular filtration rate (eGFR)) and clinical severity parameters (length of hospital stay, in-hospital
complications, coronary angiography, and echocardiography (LVEF)). After hospital discharge, 229 patients
were followed-up (2011-2022) and grouped according to the presence of major adverse cardiovascular
events (MACE). In the acute phase, WBC, hs-CRP, LDH and AST positively correlated with
maximal CK/cTnT and total in-hospital complications, and negatively with LVEF; WBC positively
correlated with cardiogenic shock and stent diameter, hs-CRP with cardiac arrest and length of hospital
stay, and LDH with stent diameter; total in-hospital complications increased the risk of in-hospital
mortality and number of significantly stenosed coronary arteries, risk of heart failure, whereas the length
of hospital stay negatively correlated with LVEF (p<0.05 all). During 10-year follow-up, LDH and clinical
severity parameters (stenosis of LAD/ACx, multivessel CAD, proximal coronary stenosis, Gensini
score, in-hospital complications) increased, while the others (normal eGFR and LVEF) reduced the risk
of total MACE (p<0.05). In conclusion, acute biomarkers have a role in predicting clinical severity but they have no role in predicting long-term prognosis (except for LDH). Total in-hospital complications,
more severe CAD, systolic dysfunction, and worse kidney function may lead to worse in-hospital and
long-term outcomes.

Keywords

Acute STEMI; Primary percutaneous coronary intervention; Long-term prognosis; Inflammation; Biomarkers

Hrčak ID:

333336

URI

https://hrcak.srce.hr/333336

Publication date:

31.12.2024.

Article data in other languages: croatian

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