Should left ventricular failure be part of the risk score in acute ischemic syndrome without ST elevation?

Background

For the identification of cardiac prognostic risk markers in the emergency room, in patients with ischemic heart syndrome without ST elevation, it is important to choose the best and the most cost-effective therapeutic strategy.

Goal

To evaluate the prognostic impact of left ventricular failure (LVF) in patients with acute ischemic syndrome without ST segment elevation.

Methods

Included were 124 patients, most of them male (58%), with average age of 68.9 ± 12.3 years. A total of 8.9% had clinical LVF symptoms at admission, and 17.7% had events in the following 180 days.

Results

LVF was present in 41.7% of the patients with combined events and only in 13.9% of patients without ischemic events.

Comparing the LVF group and the without LVF group in their admission we observed a grater prevalence of events (P = 0.02) in the first group, relative risk = 3.16 (95% confidence interval = 2.28–4.04). The positive Likelihood ratio was 4.28 and the negative Likelihood ratio was 0.8. In this multivariate analysis, LVF (P = 0.012) was the only independent predictor of events.

Conclusion

Evaluating the presence of clinical LVF is a main factor in the risk stratification of patients with acute ischemic syndrome without ST segment elevation.

Table 1