The Effect Of Demographic Factors And Comorbidities On Ejection Fraction Outcome In Acute Myocardial Infarction Patients

Abstract

Objective: Left ventricular dysfunction commonly occurs as a complication after acute myocardial infarction. This study sought to explore the occurrence of acute left ventricular dysfunction among patients who have experienced an acute myocardial infarction (AMI)

Methods: A prospective observational study was conducted at a tertiary care hospital over 12 months from February 2022 to January 2023. Non-probability convenience sampling technique was used to recruit the participants following informed consent. All patients aged 18 or more admitted with acute myocardial infarction confirmed by clinical, ECG findings and cardiac biomarkers were included in the study and patients with pre-existing valvular heart disease, previous history of myocardial infarction and history of cardiac surgery were excluded from the study. Socio-demographic details and risk factors like hypertension and diabetes were recorded, alongside presenting symptoms and vital signs. Echocardiography was performed to assess left ventricular function, including ejection fraction and other parameters. Data was analyzed utilizing SPSS version 28. The ejection fraction data were stratified into three distinct categories: 1) between 25% and 40%, 2) between 41% and 55%, and 3) between 55% and 70%. The Chi-square test was employed to assess significant differences in the proportion of patients with different demographic characteristics, co-morbidities and risk factors falling into each category. The level of statistical significance was p <0.05.

Results: 100 patients with acute myocardial infarction were recruited. 69% were male and the mean age was 61 years. Most patients (55%) had an ejection fraction (EF) between 25% and 40% and the majority of patients (63%) had acute anterior MI. The coexistence of hypertension with diabetes and smoking was prevalent (74% and 48% respectively), with significant associations (p = 0.000 and 0.02). A substantial difference in EF distribution was observed between anterior and inferior wall MI patients (p = <0.0001), with 71% of anterior MI patients having EF below 40%, compared to 27% of inferior MI patients.

Conclusion: This study provides valuable insights into the decrease in ejection fraction observed in patients with acute myocardial infarction, particularly those presenting with anterior wall MI.