Impact of Primary PCI on Left Ventricular Function Recovery and Predictive Factors in Acute Myocardial Infarction

Abstract

Objectives: To evaluate the impact of Primary Percutaneous Coronary Intervention (PCI) on Left Ventricular Function Recovery (LVFR) in patients with Acute Myocardial Infarction (AMI), with a specific focus on myocardial work efficiency, microvascular resistance, and long-term cardiac outcomes. Methodology: A total of 150 patients diagnosed with STEMI and treated with Primary PCI were included. Left Ventricular Ejection Fraction (LVEF) was assessed at baseline and again at six months post-PCI. Statistical analyses, including paired t-tests and chi-square tests, were conducted using SPSS version 26.0. Results: The mean baseline LVEF was 48.5% (range: 32%–65%), which improved significantly to 53.3% (range: 35%–70%) post-PCI, with an average increase of 7.2% (p < 0.05). The overall PCI success rate was 70%, with a significant age-wise variation: 85% in the 30–50 years group, 68% in the 51–65 years group, and 50% in patients aged 66 years and older (p = 0.02). Microvascular obstruction (MVO) was identified in 28% of patients and was significantly associated with a lower degree of LVEF improvement (p = 0.03). Younger patients demonstrated better recovery, with 76% of those aged 30–50 achieving at least a 10% LVEF improvement, compared to 50% in the 66+ group (p = 0.01). Conclusion: Primary PCI significantly enhances LVFR in AMI patients, particularly among younger individuals. Microvascular obstruction is a key factor impeding optimal recovery, underscoring the need for targeted therapeutic interventions. Future research should explore pharmacologic strategies and advanced imaging techniques to further improve outcomes.