ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Imaging
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1619262
This article is part of the Research TopicMulti-Parametric Echocardiography in the Detection of Coronary Artery DiseaseView all 6 articles
Short-Term Outcomes of Non-ST Segment Elevation Acute Coronary Syndrome After Percutaneous Coronary Intervention: A Single-Center Speckle Tracking Echocardiographic Study in Vietnam
Provisionally accepted
- 1Bach Mai Hospital, Hanoi, Vietnam, Vietnam National Heart Institute, Hanoi, Vietnam
- 2VNU- University of Medicine and Pharmacy, Hanoi, Vietnam, Hanoi, Vietnam
- 3Department of Cardiology, Hanoi Medical University, Hanoi, Vietnam
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Background: Data on the prognostic value of myocardial strain in patients with non– ST-segment elevation acute coronary syndrome (NSTE-ACS) from low-and middle-income countries remain scarce. This study aimed to evaluate the prognostic significance of left ventricular myocardial strain in patients with NSTE-ACS after successful percutaneous coronary intervention (PCI) in Vietnam. Methods: In this prospective cohort study, consecutive patients diagnosed with NSTE-ACS and treated with PCI underwent conventional and speckle-tracking echocardiography within 24 hours post-PCI to assess myocardial function, including global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS). Patients were followed for 12 months. The association between echocardiographic parameters and major adverse cardiovascular events (MACE) was analyzed using Kaplan–Meier survival curves and Cox proportional hazards models. Prognostic performance was assessed using receiver operating characteristic (ROC) curves, area under the curve (AUC), and other diagnostic indices. Results: A total of 127 patients were included (mean age 65.5 ± 10.5 years; 71.3% male). During 12 months of follow-up, 26 patients (20.5%) experienced MACE. The MACE group had significantly impaired GLS, GCS, and GRS compared with the event-free group (all p <0.0001). In multivariable analysis, only higher (less negative) GLS remained an independent predictor of MACE (HR 1.62; 95% CI 1.26–2.08; p < 0.001). GLS demonstrated the strongest prognostic performance among echocardiographic variables, with an AUC of 0.967 (95% CI 0.941–0.994). At the optimal cutoff, an GLS ≥ –16% demonstrated a sensitivity of 100% (95% CI, 86.8–100) and a specificity of 85.1% (95% CI, 76.7–91.4). Conclusion: In patients with NSTE-ACS, post-PCI GLS, GCS, and GRS were significantly more impaired in those who developed MACE compared with the event-free group, indicating underlying cardiac dysfunction or myocardial injury. Among these parameters, GLS emerged as an independent predictor of MACE after PCI and may serve as a valuable tool for identifying high-risk patients.
Keywords: Non-ST segment elevation acute coronary syndrome, global longitudinalstrain, Global circumferential strain, global radial strain, prognosis, left ventricularfunction
Received: 27 Apr 2025; Accepted: 29 Sep 2025.
Copyright: © 2025 Nguyen, Trinh, Nguyen, Do and Le. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hoai Thi Thu Nguyen, hoainguyen1973@gmail.com
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