Prolonged pain-to-balloon time still impairs midterm left ventricular function following STEMI
Abstract Background ST-elevation myocardial infarction (STEMI) demands near-time reperfusion to reduce the risk of long-term heart failure. This study evaluates the proportion of impaired left ventricular ejection fraction (LVEF) following STEMI in the context of current healthcare settings at a ter...
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BMC
2025-01-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-025-04484-3 |
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| author | Dominik Felbel Sabrina Fackler Rachel Michalke Michael Paukovitsch Matthias Gröger Mirjam Keßler Nicoleta Nita Yannick Teumer Leonhard Schneider Armin Imhof Dominik Buckert Wolfgang Rottbauer Sinisa Markovic |
| author_facet | Dominik Felbel Sabrina Fackler Rachel Michalke Michael Paukovitsch Matthias Gröger Mirjam Keßler Nicoleta Nita Yannick Teumer Leonhard Schneider Armin Imhof Dominik Buckert Wolfgang Rottbauer Sinisa Markovic |
| author_sort | Dominik Felbel |
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| description | Abstract Background ST-elevation myocardial infarction (STEMI) demands near-time reperfusion to reduce the risk of long-term heart failure. This study evaluates the proportion of impaired left ventricular ejection fraction (LVEF) following STEMI in the context of current healthcare settings at a tertiary care center equipped with the most advanced and up-to-date standards of care. Methods Patients experiencing STEMI as their first manifestation of coronary artery disease were analyzed, as these individuals had no prior experience with heart-related chest pain. LVEF was assessed by levocardiography at admission and semiautomatically using TOMTEC in patients with eligible full-cycle echocardiography of 2- and 4-chamber view available at discharge and 1-year follow-up (FU). Pain-to-balloon time was divided into quartiles (Q) [0-111, 112–159, 160–246 and 247–784 min]. Multiple logistic regression analysis identified independent predictors of reduced LVEF < 50% at 1-year FU. Results A total of 1,379 consecutive STEMI patients were reviewed from 2010 to 2017, with 130 meeting the inclusion criteria. Mean age was 63 ± 12 years, 75% were male, 14% had diabetes, 72% had arterial hypertension, and 56% had history of smoking. LVEF was reduced in 94% of patients at admission, 69% at discharge, and remained reduced in 45% at the 1-year follow-up. Anterior wall myocardial infarction (OR 3.2 [95%-CI 1.2–6.9], p = 0.018) and increasing pain-to-balloon time across quartiles (Q2: OR 15.7 [95%-CI 1.8–140.4], p = 0.014; Q4: OR 33.7 [3.4–278.7] p = 0.002) were independently associated with reduced LVEF at 1 year. Conclusion Despite optimal medical management and advanced healthcare structures, nearly half of patients with STEMI as their first presentation of coronary artery disease continue to exhibit reduced LVEF at 12-months. Anterior wall myocardial infarction and pain-to-balloon time exceeding 2 h remain independent predictors of left ventricular dysfunction. Further improvements in healthcare systems and public education are essential to reduce treatment delays and improve long-term outcomes. |
| format | Article |
| id | doaj-art-42c5daa8f4fa45949837a4c9d1eeaf9c |
| institution | Kabale University |
| issn | 1471-2261 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-42c5daa8f4fa45949837a4c9d1eeaf9c2025-01-26T12:14:17ZengBMCBMC Cardiovascular Disorders1471-22612025-01-0125111010.1186/s12872-025-04484-3Prolonged pain-to-balloon time still impairs midterm left ventricular function following STEMIDominik Felbel0Sabrina Fackler1Rachel Michalke2Michael Paukovitsch3Matthias Gröger4Mirjam Keßler5Nicoleta Nita6Yannick Teumer7Leonhard Schneider8Armin Imhof9Dominik Buckert10Wolfgang Rottbauer11Sinisa Markovic12Department of Cardiology, Ulm University Heart CenterDepartment of Cardiology, Ulm University Heart CenterDepartment of Cardiology, Ulm University Heart CenterDepartment of Cardiology, Ulm University Heart CenterDepartment of Cardiology, Ulm University Heart CenterDepartment of Cardiology, Ulm University Heart CenterDepartment of Cardiology, Ulm University Heart CenterDepartment of Cardiology, Ulm University Heart CenterDepartment of Cardiology, Ulm University Heart CenterDepartment of Cardiology, Ulm University Heart CenterDepartment of Cardiology, Ulm University Heart CenterDepartment of Cardiology, Ulm University Heart CenterDepartment of Cardiology, Ulm University Heart CenterAbstract Background ST-elevation myocardial infarction (STEMI) demands near-time reperfusion to reduce the risk of long-term heart failure. This study evaluates the proportion of impaired left ventricular ejection fraction (LVEF) following STEMI in the context of current healthcare settings at a tertiary care center equipped with the most advanced and up-to-date standards of care. Methods Patients experiencing STEMI as their first manifestation of coronary artery disease were analyzed, as these individuals had no prior experience with heart-related chest pain. LVEF was assessed by levocardiography at admission and semiautomatically using TOMTEC in patients with eligible full-cycle echocardiography of 2- and 4-chamber view available at discharge and 1-year follow-up (FU). Pain-to-balloon time was divided into quartiles (Q) [0-111, 112–159, 160–246 and 247–784 min]. Multiple logistic regression analysis identified independent predictors of reduced LVEF < 50% at 1-year FU. Results A total of 1,379 consecutive STEMI patients were reviewed from 2010 to 2017, with 130 meeting the inclusion criteria. Mean age was 63 ± 12 years, 75% were male, 14% had diabetes, 72% had arterial hypertension, and 56% had history of smoking. LVEF was reduced in 94% of patients at admission, 69% at discharge, and remained reduced in 45% at the 1-year follow-up. Anterior wall myocardial infarction (OR 3.2 [95%-CI 1.2–6.9], p = 0.018) and increasing pain-to-balloon time across quartiles (Q2: OR 15.7 [95%-CI 1.8–140.4], p = 0.014; Q4: OR 33.7 [3.4–278.7] p = 0.002) were independently associated with reduced LVEF at 1 year. Conclusion Despite optimal medical management and advanced healthcare structures, nearly half of patients with STEMI as their first presentation of coronary artery disease continue to exhibit reduced LVEF at 12-months. Anterior wall myocardial infarction and pain-to-balloon time exceeding 2 h remain independent predictors of left ventricular dysfunction. Further improvements in healthcare systems and public education are essential to reduce treatment delays and improve long-term outcomes.https://doi.org/10.1186/s12872-025-04484-3STEMIPain-to-balloon timeLeft ventricular dysfunction |
| spellingShingle | Dominik Felbel Sabrina Fackler Rachel Michalke Michael Paukovitsch Matthias Gröger Mirjam Keßler Nicoleta Nita Yannick Teumer Leonhard Schneider Armin Imhof Dominik Buckert Wolfgang Rottbauer Sinisa Markovic Prolonged pain-to-balloon time still impairs midterm left ventricular function following STEMI BMC Cardiovascular Disorders STEMI Pain-to-balloon time Left ventricular dysfunction |
| title | Prolonged pain-to-balloon time still impairs midterm left ventricular function following STEMI |
| title_full | Prolonged pain-to-balloon time still impairs midterm left ventricular function following STEMI |
| title_fullStr | Prolonged pain-to-balloon time still impairs midterm left ventricular function following STEMI |
| title_full_unstemmed | Prolonged pain-to-balloon time still impairs midterm left ventricular function following STEMI |
| title_short | Prolonged pain-to-balloon time still impairs midterm left ventricular function following STEMI |
| title_sort | prolonged pain to balloon time still impairs midterm left ventricular function following stemi |
| topic | STEMI Pain-to-balloon time Left ventricular dysfunction |
| url | https://doi.org/10.1186/s12872-025-04484-3 |
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