Abstract: Objective To investigate the predictors of left ventricular systolic dysfunction (LVSD) in the elderly patients with acute anterior ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). Methods A total of 374 elderly patients with acute anterior STEMI who underwent primary PCI in the First Affiliated Hospital of Jinan University from January 2013 to September 2019 were divided into LVSD group [left ventricular ejection fraction (LVEF)≤40%, n=120] and control group (LVEF>40%, n=254) according to the lowest LVEF measured by color Doppler echocardiography from post-PCI to discharge. The clinical data, biochemical results, echocardiographic and angiographic data of the two groups were compared. Multivariate Logistic regression analysis was performed to evaluate the independent predictors of LVSD. Results The incidence rate of LVSD in the elderly patients with acute anterior STEMI after PCI was 32.09%(120/374). Multivariate Logistic regression analysis showed that the criminal vessel thrombolysis in myocardial infarction (TIMI) flow grade≤1(OR=2.738, 95%CI:1.516-4.943, P=0.001),admission heart rate (OR=1.028, 95%CI:1.012-1.045, P=0.001), admission systolic blood pressure (OR=0.985,95%CI: 0.976-0.996,P=0.006), left ventricular end-diastolic diameter (OR=1.132,95%CI:1.074-1.192, P<0.001), left main coronary artery lesion (OR=2.571, 95%CI: 1.106-5.974,P=0.028), peak level of N-terminal B-type natriuretic peptide (OR=1.095,95%CI:1.055-1.137, P<0.001) were independent predictors of LVSD in the elderly patients with acute anterior STEMI after PCI. Conclusions Criminal vessel TIMI flow grade≤1, admission heart rate, admission systolic blood pressure, left ventricular end-diastolic diameter, left main coronary artery lesion and peak level of N-terminal B-type natriuretic peptide are independently associated with LVSD in the elderly patients with acute anterior STEMI after PCI.

Key words: myocardial infarction, percutaneous coronary intervention, left ventricular systolic dysfunction, predictor, aged