(1) Background: Left ventricular ejection fraction (LVEF) is traditionally used to assess prognosis in acute ST-elevation myocardial infarction (STEMI) patients. However, LV myocardial work (MW), evaluated echocardiographically, offers additional prognostic information by considering loading conditions. (2) Methods: This prospective study investigated the prognostic value of MW indices in 119 consecutive STEMI patients treated with primary percutaneous coronary angioplasty, stratified into three LVEF categories: reduced (≤40%), mildly reduced (41–49%), and preserved LVEF (≥50%). Transthoracic echocardiography was performed before discharge, and the primary endpoint included heart failure hospitalization, ventricular arrhythmias, all-cause mortality and new acute coronary syndromes. (3) Results: Patients with preserved or mildly reduced LVEF had higher global longitudinal strain, global work index, global constructive work (GCW), and global work efficiency, as well as lower global wasted work (GWW), compared to those with reduced LVEF. GCW was the strongest predictor of adverse outcomes in the preserved LVEF group (AUC = 0.730, p = 0.035), while GWW demonstrated robust predictive performance in the reduced LVEF group (AUC = 0.787, p = 0.001). (4) Conclusions: MW indices, particularly GCW and GWW, provide significant prognostic value in distinct LVEF categories in STEMI patients. These findings indicate that MW enhances risk stratification and informs management in this patient population.

Background/Objectives: Obesity is increasingly common among patients with acute ST-segment elevation myocardial infarction (STEMI), potentially influencing both clinical evaluation and outcomes. Traditional echocardiographic metrics may be suboptimal for prognosis estimation in this population. Left ventricular myocardial work (LVMW) represents an emerging, load-adjusted marker of myocardial performance. This study aimed to assess the prognostic relevance of LVMW in obese STEMI patients. Methods: A total of 143 patients presenting with STEMI were prospectively enrolled and categorized based on their obesity status (body mass index ≥30 kg/m²). LVMW parameters were measured using echocardiography within 72 ± 24 h of hospital admission. The patients were monitored for major adverse cardiovascular events (MACE), defined as cardiovascular death, malignant ventricular arrhythmias, or unplanned hospitalizations due to heart failure or acute coronary syndrome. Results: During a median follow-up of 13 months (interquartile range: 6–28 months), MACE occurred in 30 patients (21%). Among obese individuals, left ventricular global work efficiency (LVGWE) emerged as the most robust predictor of adverse events, with an area under the receiver operating characteristic curve of 0.736 (95% confidence interval [CI]: 0.559–0.914; p = 0.009). A threshold value of 79% for LVGWE was identified as optimal for predicting MACE. Kaplan–Meier analysis revealed significantly lower event rates in obese patients with LVGWE ≥79% (log-rank p = 0.006). In univariate Cox regression analysis, LVGWE <79% was associated with a markedly elevated risk of MACE in obese patients (hazard ratio [HR] = 5.59; 95% CI: 1.33–23.50; p = 0.019), and remained a significant predictor in the overall cohort (HR = 2.73; 95% CI: 1.26–5.90; p = 0.010). Conclusions: LVGWE demonstrates strong prognostic utility in STEMI, particularly among obese patients. The incorporation of myocardial work indices into routine evaluation may enhance risk stratification and guide management in this high-risk subgroup.

Cardiovascular diseases (CVDs) persist as a significant contributor to global morbidity and mortality despite advances in medical technology. Air pollution has emerged as a significant contemporary challenge due to increased energy consumption and rapid economic development. The study utilized multivariable Poisson regression and Distributed Lag Models (DLM) to assess the link between brief exposure to outdoor air pollutants (PM₁₀—particulate matter with a diameter ≤ 10 μm, NO₂—nitrogen dioxide, and O₃—ozone) and the risk of acute myocardial infarction with ST-segment elevation (STEMI) hospitalization, stratified by season. The research was conducted from January 2019 to December 2021 at the University Hospital in Timisoara, Romania, and daily records were collected for STEMI admissions, atmospheric pollutant levels, and meteorological parameters. The most pronounced impacts were observed with each 10 μg/m³ increase at lag 07 for PM₁₀ during summer, leading to a 2% increase in STEMI admissions, and for NO₂ during spring at lag 07, resulting in a 0.9% rise in CVD incidence. Men, middle-aged adults, and older adults exhibited greater susceptibility to elevated NO₂ and PM₁₀ concentrations than women and younger individuals. Brief exposure to diverse air pollutants heightens the likelihood of hospitalization due to STEMI, particularly among men and adults over 45. Effective measures must be implemented to mitigate these impacts, especially for vulnerable populations.