Correlation between development of LV aneurysm, „time-to-balloon” and severity of CAD in acute anterior myocardial infarction

Introduction: Anterior myocardial infarction (AMI) has the worst outcome because of the large affected area. 5% of patients with AMI develop left ventricular aneurysm (LVA) in the first 2 weeks after onset, their quality of life being severely damaged.
Objective: The aim of this study consisted of the follow up of patients diagnosed with AMI, for incidence of LVA correlated to „time-to-balloon” for primary PCI and to severity of CAD.
Methods: T he retrospective study was conducted on 20 patients assessed at the Interventional Department in the Institute of Cardiovascular Diseases from Timisoara, between January and June 2017, who underwent primary PCI on LAD due to acute AMI. 13 patients were addressed within the same hospital and 7 were addressed from other departments. After PCI, follow-up was made at 3 months through clinical examination, ECG and ETT.
Results: The group consisted of 85% men (n=17) and 15% women (n=3). All the patients were >60y old and underwent primary PCI on LAD for AMI. The mean time from first medical contact (FMC) to primary PCI was 9.31±1.52 hours. 30% of patients developed LVA. In the 6 patients who developed LVA, „time-to-balloon” was 2 hours, 3 hours, 7 hours, and 10 hours in 2 cases and 72 hours in one case. The Spearman correlation between the admission hours and the inciden-ce of LVA was highly statistical significant (rs=0.352, p<0.001). The mean time±SD from symptom onset to intervention in patients without aneurysm was signi-ficantly lower than in patients with LVA (5.85±4.2 ho-urs vs. 17.33±24.64 hours, p=0.013). CAD severity was monovascular in 45% (n=9), bivascular in 20% (n=4) and trivascular in 35% (n=7). The Spearman corre-lation between the severity of CAD and the develop-ment of LVA had high statistical significance (rs=0.421, p=0.041).
Conclusions: The best predictor for LVA development is the time from onset of simptomatology to PCI. Se-verity of CAD has also a good predictive value for LVA occurence.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)