Correlation between Left Ventricular Ejection Fraction and Zwolle Risk Score in Post Primary Percutaneous Coronary Intervention Patients

Author : A. Pudjiastuti, A. A. Asrial, A. Sariningrum, S. N. Sofia
Upload Date : 19-04-2018

Background: Zwolle Risk Score (ZRS) is a six-item score using age, time to reperfusion, anterior infarction, TIMI flow post angioplasty, angiography three-vessel coronary disease (3VD), and Killip class in post primary percutaneous coronary intervention (pPCI) patients. ZRS score < 3 define as low risk group which can be safely discharged within 72 hours, while ZRS score >3 categorized as high risk group. Left Ventricular Ejection Fraction (LVEF) known as key of prognostic factor in ST elevation myocardial infarction (STEMI) management. LVEF doesn’t include in ZRS scoring while data that correlate LVEF and ZRS was still sparse.

Method: We analyzed 53 patients with STEMI treated with PPCI divided into Low Risk and High Risk group based on ZRS in RSUP Dr.Kariadi Semarang. Data collected from medical record, angiography and echocardiography study. LVEF assessed by biplane study of echocardiography.

Result: There were 34(64.2%) patients in Low risk group and 19(35.8%) in high risk group. Patients in low risk group were younger (51.02+10.84 vs 59.21+10.14 years old, p=0.009)  and had more killip class I (34(64.1%) vs 7(13.2%), p<0.001) in compare to high risk group. Low risk group had higher LVEF (48.67+7.80 vs 42.78+15.55 %, p=0.072) and better renal function eGFR (56.36 + 22.28 vs 45.40+18.71 ml/min, p=0.063) but not statistically significant. No statistically significant difference in body mass index (BMI), history of diabetes, hypertension, smoking status, anterior wall infarction, heart rate, systolic blood pressure, haemoglobin, leukocyte, and platelet level at admission. There were significantly possitive correlation between kategorized preserved EF(>40%) and reduced EF(<40%) to low risk and high risk ZRS (r=0.615, P=0.027)

Conclusion: LV dysfunction indicated by LVEF had significantly positive correlation with ZRS scoring. Low ZRS patients are younger and had more killip class I.

KEYWORDS : LVEF, Zwolle Risk Score, STEMI, early discharge, post primary PCI

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