Risk factors for nosocomial heart failure in patients with acute anterior ST-segment elevation myocardial infarction

Yang Peng; Zhuang Jinlong; Ruan Fahui

doi:10.3969/j.issn.1674-4055.2024.11.18

Abstract：Objective To analyze the risk factors of heart failure in patients with acute anterior ST-segment elevation myocardial infarction(STEMI)during hospitalization period.Methods The clinical materials of patients with acute anterior STEMI undergone PCI were retrospectively analyzed in Dongnan Hospital of Xiamen University from Jan.2015 to Dec.2022.All patients were divided,according to occurrence of heart failure(HF),into HF group and non-HF group.The clinical materials were compared between 2 groups.The independent risk factors of nosocomial HF were analyzed by using multi-factor Logistic regression analysis.The predictive efficacy of the risk factors was analyzed by using ROC curve and AUC analyses.Results There were totally 570 patients with acute anterior STEMI,and 309(54.21％)in HF group and 261(45.79％)in non-HF group.The results of multi-factor Logistic regression analysis showed that ventricular arrhythmias(VA,OR=5.583,95％CI:2.240～13.917,P＜0.001),community-acquired pneumonia(CAP,OR=4.689,95％CI:2.371～9.275,P＜0.001),increased age(OR=1.029,95％CI:1.01 1～1.047,P=0.001)and higher N-terminal pro-brain natriuretic peptide(NT-proBNP,OR=1.082,95％CI:1.055～1.110,P＜0.001)were independent risk factors of nosocomial HF,and increased left ventricular ejection fraction(LVEF,OR=0.958,95％CI:0.936～0.982,P＜0.001)was a protective factor.In predicting nosocomial HF in patients with acute anterior STEMI,AUC of NT-proBNP peak value was 0.753,and the optimal diagnostic cutoff was 2031 pg/dl.Conclusion VA,CAP,increased age,decreased LVEF and increased NT-proBNP peak value are risk factors of nosocomial HF in patients with acute anterior STEMI.