0007 : Low left ventricle ejection fraction in STEMI's patients: experience of University Hospital of Casablanca

Heart failure is a clinical syndrome resulting from impaired function of the myocardium. This study sought to describe and compare specific characteristics, baseline clinical profile and intrahospital mortality of patients admitted in intensive care unit (ICU) for acute myocardial infarction with sustained STsegment elevation (STEMI) according to their left ventricle ejection fraction (LVEF).MethodsWe included 79 patients over first quarter 2013. Patients with LVEF < 40% constituted group1 (n=22; 27.8%) and were compared to patients’ group2, n=57; 72.2% with LVEF ≥40%.For each patient, cardiovascular history, maximum Killip class, period chest pain, heart rate (HR), troponine level, kidney function and CRP were recorded.ResultsThe average age was 59.6 years. Patients’ group1 were older: 64.4 years against 57.8 years for patients’ group2. Sex ratio did not differ with a male predominance 68% in both groups.Patients’ group1 were more frequently hypertensive (50% vs. 36.84%) and had history of coronary heredity in 9% of cases vs. 1.75% in group2. They presented in a shorter chest pain time (5.4 hours vs. 6.7 hours) and were more frequentely tachycardiac (HR≥100 bpm): 40.9% vs. 17.5% in group2. Patients in group 1 had significantly more congestive heart failure (22.72% of patients were ≥killip II vs. 1.75% in group2) (p=0.006). Troponines were positive in 95% in both groups with an average of 47.01 ng/ml in group1 vs 42.38 ng/ml in group2. Group1 presented lower mean Glomerular Filtration Rate (GFR): 58,2ml/min vs 87,16mL/min and higher CRP (average 93.11mg/l vs 50.28mg/l in group2). The short term Survival was higher in group2 (94.74% vs 86.37%).ConclusionOur study shows that older age, tachycardia, CHF, prior hypertensive, and higher CRP were more associated with moderate to severe impaired LVEF at admission in patients with STEMI. We think taht a rapid assessment of LVEF in the IUC will identify a population at risk who needs sharper hospital care