Lung Ultrasound in the Acute Phase of ST-Segment-Elevation Acute Myocardial Infarction

BACKGROUND: Lung ultrasound (LUS) has emerged as a useful tool in the acute phase of patients admitted for ST-segment- elevation myocardial infarction. However, its long-term significance remains uncertain, and risk scores do not include LUS findings as a predictor. This study aims to assess the 1-y...

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Detalles Bibliográficos
Autores: Vidal Burdeus, María|||0000-0002-9823-5021, Simón-Ramón, C.|||0000-0003-1136-4005, Sionis, Alessandro|||0000-0003-0843-9512, Izquierdo Marquisá, Andrea|||0000-0002-3610-7497, Farré, Núria|||0000-0003-3110-6572, Tizón-Marcos, Helena|||0000-0001-7942-9413, Milà Pascual, Laia|||0009-0007-4932-657X, Carreras-Mora, José|||0000-0003-2519-5177, Rodríguez-González, Clara, Rodríguez-Sotelo, Laura|||0000-0001-7825-5714, Giralt-Borrell, T., Martínez Membrive, María José|||0000-0002-3400-7003, Cainzos-Achirica, Miguel|||0000-0002-3805-9089, García Picart, Joan, Vaquerizo Montilla, Beatriz|||0000-0002-1428-3596, Rivas-Lasarte, Mercedes|||0000-0002-8704-3104, Ribas Barquet, Núria|||0000-0003-1492-5285
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:324383
Acceso en línea:https://ddd.uab.cat/record/324383
https://dx.doi.org/urn:doi:10.1161/JAHA.124.035688
Access Level:acceso abierto
Palabra clave:B-lines
GRACE score
STEMI
lung ultrasound
Descripción
Sumario:BACKGROUND: Lung ultrasound (LUS) has emerged as a useful tool in the acute phase of patients admitted for ST-segment- elevation myocardial infarction. However, its long-term significance remains uncertain, and risk scores do not include LUS findings as a predictor. This study aims to assess the 1-year prognostic value of LUS and its ability to enhance existing risk scores. METHODS AND RESULTS: This is a multicenter prospective cohort study involving 373 patients with ST-segment-elevation myocardial infarction. LUS was performed during the first 24 hours after angiography. LUS results were assessed both as a categorical (wet/dry lung) and continuous variable (LUS score). The primary end point comprised the following major adverse cardiovascular events: all-cause mortality or hospitalization for heart failure, acute coronary syndrome, or stroke within 1 year. We also evaluated whether LUS could enhance the predictive value of the GRACE (Global Registry of Acute Coronary Events) score. Major adverse cardiovascular events occurred in 51 (13.7%) patients over a median follow-up of 368 days. After multi-variate analysis, the LUS score was an independent predictor (hazard ratio [HR], 1.06 [95% CI, 1.01-1.10]; P=0.009] for each additional B-line), whereas the categorical classification was an independent predictor in patients with ST-segment-elevation myocardial infarction Killip I (HR, 3.12 [95% CI, 1.34-7.31]; P=0.009). Incorporating LUS into GRACE resulted in a net reclassification index of 31.6% and a significant increase in the area under the curve; GRACE alone scored 0.705 compared with GRACE+LUS 0.791 (P=0.002). CONCLUSIONS: Detecting B-lines on LUS at the acute phase predicts major adverse cardiovascular events at 1 year in patients with ST-segment-elevation myocardial infarction and enhances the predictive value of the GRACE score. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04526535.

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