Left Ventricular Global Function Index: A Potential Predictor of Mortality and Major Adverse Cardiovascular Events in NSTEMI Patients

Background and Objectives: The Left Ventricular Global Function Index (LVGFI) is a comprehensive marker of cardiac performance that integrates volumetric and functional parameters of the left ventricle. While its prognostic value in chronic cardiovascular diseases is well-documented, limited evidence exists for its utility in non-ST elevation myocardial infarction (NSTEMI). This study aimed to evaluate LVGFI as a predictor of three-year mortality and major adverse cardiovascular events (MACE) in NSTEMI patients. Methods: This retrospective cohort study included 432 NSTEMI patients divided into tertiles based on LVGFI values: T1 (low), T2 (intermediate), and T3 (high). LVGFI values were derived from echocardiographic imaging. Kaplan-Meier survival analysis was used to assess outcomes, and Cox proportional hazards models, adjusted for demographics and clinical covariates (age, sex, body mass index, and cardiovascular risk factors), determined the association between LVGFI tertiles and three-year outcomes. Results: The average age and sex distribution were similar across tertiles (T1: 70 years, T2: 67 years, T3: 68 years) with no significant differences in cardiovascular risk factors or most laboratory parameters, including glucose and hematological counts. However, significant differences were noted in Body Surface Area (higher in T3), platelet counts (higher in T1), and triglyceride levels (lower in T3). The ROC analysis identified an optimal LVGFI cut-off of 23.22 for predicting three-year mortality, with a sensitivity of 72% and specificity of 75% (AUC: 0.81; 95% CI: 0.74-0.87, p < 0.001). Patients in the lowest LVGFI tertile (T1) exhibited a three-year mortality rate of 25%, compared to 2.1% in the highest tertile (T3). After adjustment, the hazard ratio (HR) for mortality was significantly elevated in T1 (HR 11.86; 95% CI: 3.60-39.10) compared to T3. Similarly, MACE rates were highest in T1 (27.1%) and lowest in T3 (7.6%), underscoring LVGFI’s prognostic value beyond traditional parameters. Conclusion: LVGFI is a significant independent predictor of three-year mortality and MACE in NSTEMI patients. It offers a holistic assessment of cardiac function and may enhance clinical risk stratification models for managing high-risk patients. Further prospective studies are warranted to validate its broader clinical utility.