Objectives To assess whether a simple echocardiographic grading system reflecting the severity and stage of myocardial injury can stratify long-term mortality risk among patients with first-time ST-segment elevation myocardial infarction (STEMI). Participants Consecutive patients with first-time STEMI between June 2016 and June 2024 who survived to hospital discharge and underwent echocardiography were included.
A total of 2708 patients were enrolled and followed up for a median of 5.5 years (IQR: 5.3–6.4). Results Patients were stratified into four grades: 1392 (51.4%) were classified as Grade 1; 905 (33.4%) as Grade 2; 350 (12.9%) as Grade 3; and 61 (2.3%) as Grade 4.
During follow-up, long-term all-cause mortality increased stepwise across increasing echocardiographic grades. In multivariable Cox regression analysis, the baseline grading remained an independent predictor of long-term mortality after adjustment (adjusted HR for Grade 4 vs Grade 1: 3.35, 95% CI 1.34 to 8.38, p<0.01).
BMJ Open published a clinical update in Research Highlights on 21 Apr 2026.
The item focuses on Echocardiographic grading for long-term mortality risk stratification after first-time ST-segment elevation myocardial infarction: a multicentre cohort study.
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