Prognostic importance of lung ultrasound sonography in patients with st-elevation myocardial infarction

Abstract Background Lung ultrasonography (LUS) is a relatively new method for assessing subclinical lung congestion. It has been approved to predict prognosis in heart failure; however, the importance of LUS as a prognostic marker in acute myocardial infarction is not well studied. Purpose Our goal was to assess the predictive value of LUS in patients with ST-segment elevation myocardial infarction(STEMI). Methods The study involved 140 patients in total. The primary percutaneous coronary intervention was performed on all patients. We used the 8-zone approach to perform LUS in patients with STEMI within 6 hours of admission. LUS detected lung congestion as B-lines, and the sum of the B-line from 8 chest zones was determined. The patients were divided into two groups depending on the amounts of B lines. Patients with a number of B-lines < 15 were included in Group 1 (70 patients) and patients with a B-lines ≥ 15 were included in Group 2 (70 patients). The NT-proBNP analysis was performed both upon admission and six months later. The groups' other characteristics were similar. The primary outcome was a 6-month death rate after admission for STEMI. The secondary endpoint was NT-proBNP level over six months and cardiac cause of rehospitalization. Results NT-proBNP levels were, on average, 1471.6±272.8pg/ml in group 1 and 1512.3 ±285.8pg/ml in group 2 at the beginning of the study (p=0.39). It was 653.5±241.6 pg/ml and 857.4±217.8pg/ml, respectively, at the end of six months (p < 0.0001). Cardiovascular mortality during follow-up was 2.86 % in group 1 and 12.86 % in group 2 (p =0.029), and hospitalization for a cardiac cause was 7.14% and 18.57%, respectively (p =0.044). Conclusions LUS may be used as part of the initial risk stratification in STEMI patients because it provides important prognostic information. B-lines detected by lung ultrasound can be an independent predictor of poor prognosis in STEMI patients.