Lung Ultrasound in the Acute Phase of ST-Segment-Elevation Acute Myocardial Infarction : 1-Year Prognosis and Improvement in Risk Prediction
Vidal-Burdeus, M. (Hospital Universitari Vall d'Hebron)
Simón-Ramón, C. (Institut de Recerca Sant Pau)
Sionis, Alessandro (Institut de Recerca Sant Pau)
Izquierdo-Marquisá, A. (Hospital del Mar (Barcelona, Catalunya))
Farré, Núria (Institut Hospital del Mar d'Investigacions Mèdiques)
Tizón-Marcos, Helena (Institut Hospital del Mar d'Investigacions Mèdiques)
Milà-Pascual, L. (Hospital Universitari Vall d'Hebron)
Carreras-Mora, José (Universitat Pompeu Fabra)
Rodríguez-González, Clara (Hospital del Mar (Barcelona, Catalunya))
Rodríguez-Sotelo, Laura (Institut de Recerca Sant Pau)
Giralt-Borrell, T. (Universitat Pompeu Fabra)
Martínez-Membrive, María J. (Hospital del Mar (Barcelona, Catalunya))
Cainzos-Achirica, Miguel (Institut Hospital del Mar d'Investigacions Mèdiques)
García-Picart, Joan (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Vaquerizo Montilla, Beatriz (Institut Hospital del Mar d'Investigacions Mèdiques)
Rivas-Lasarte, Mercedes (Puerta de Hierro Majadahonda University Hospital)
Ribas-Barquet, Núria (Institut Hospital del Mar d'Investigacions Mèdiques)
Universitat Autònoma de Barcelona. Departament de Medicina

Fecha:	2024
Resumen:	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.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	B-lines ; GRACE score ; STEMI ; lung ultrasound
Publicado en:	Journal of the American Heart Association. Cardiovascular and cerebrovascular disease, Vol. 13, Num. 21 (May 2024) , art. e035688, ISSN 2047-9980

DOI: 10.1161/JAHA.124.035688
PMID: 39470045

10 p, 1.0 MB

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