Lung ultrasound in the acute phase of ST-segment-elevation acute myocardial infarction: 1-year prognosis and improvement in risk prediction

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• dc.contributor.author Carreras-Mora, José
• dc.contributor.author Vidal Burdeus, María
• dc.contributor.author Rodríguez González, Clara
• dc.contributor.author Simón-Ramón, Clara
• dc.contributor.author Rodríguez Sotelo, Laura
• dc.contributor.author Sionis, Alessandro
• dc.contributor.author Giralt Borrell, Teresa
• dc.contributor.author Martínez Membrive, María José
• dc.contributor.author Izquierdo-Marquisá, Andrea
• dc.contributor.author Farré López, Núria
• dc.contributor.author Cainzos-Achirica, Miguel
• dc.contributor.author Tizón-Marcos, Helena
• dc.contributor.author Garcia-Picart, Joan
• dc.contributor.author Milà Pascual, Laia
• dc.contributor.author Vaquerizo Montilla, Beatriz
• dc.contributor.author Rivas-Lasarte, Mercedes
• dc.contributor.author Ribas Barquet, Núria
• dc.date.accessioned 2025-01-22T15:55:38Z
• dc.date.available 2025-01-22T15:55:38Z
• dc.date.issued 2024
• dc.description.abstract 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 multivariate 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.
• dc.format.mimetype application/pdf
• dc.identifier.citation Carreras-Mora J, Vidal-Burdeus M, Rodríguez-González C, Simón-Ramón C, Rodríguez-Sotelo L, Sionis A, et al. Lung ultrasound in the acute phase of ST-segment-elevation acute myocardial infarction: 1-year prognosis and improvement in risk prediction. J Am Heart Assoc. 2024 Nov 5;13(21):e035688. DOI: 10.1161/JAHA.124.035688
• dc.identifier.doi http://dx.doi.org/10.1161/JAHA.124.035688
• dc.identifier.issn 2047-9980
• dc.identifier.uri http://hdl.handle.net/10230/69245
• dc.language.iso eng
• dc.publisher American Hearth Association
• dc.relation.ispartof J Am Heart Assoc. 2024 Nov 5;13(21):e035688
• dc.rights © 2024 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword B‐lines
• dc.subject.keyword GRACE score
• dc.subject.keyword STEMI
• dc.subject.keyword Lung ultrasound
• dc.title Lung ultrasound in the acute phase of ST-segment-elevation acute myocardial infarction: 1-year prognosis and improvement in risk prediction
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion