Prognostic implications of ischemic mitral regurgitation following non-ST-Segment elevation acute myocardial infarction
International Archives of Medicine
Ischemic mitral regurgitation (MR) is a common complication of acute myocardial infarction and has a negative impact on prognosis. However, few studies have been carried out on MR after non-ST-segment elevation acute myocardial infarction (NSTEMI). Aim: Investigate the clinical predictors of ischemic MR and its impact on the outcome after 1st NSTEMI. Methods: 40 consecutive patients were selected after a first NS-TEMI. Each underwent echocardiography and coronary angiography during their
... l admission. Patients were divided into two groups according to the presence or absence of MR at echocardiography: Group I: 20 patients without MR, Group II: 20 patients with MR. The patients were followed up clinically for at least one year. The incidence of readmission for heart failure, unstable angina, reinfarction, or all combined (i.e, major adverse cardiac event [MACE]) was recorded. Results: The patients' mean age was 59.62±10.97 years and 67.5 % were male. They were followed-up for a median of 640.5 days. No significant differences between both groups regarding baseline data, cardiac isoenzymes, or revascularization (P > 0.05), but there was significantly increased number of diseased coronary arteries in MR group (P 0.04). LA diameter was significantly increased with decreased LVEF% and increased wall motion abnormalities in MR group ((P < 0.05). During follow-up period, more admissions for unstable angina were seen in patients with MR but with little significance (P 0.05). Regarding MACE, a greater incidence was found in the MR group (P < 0.05). Using Kaplan-Meier curves, a long-term association It is well known through many studies the adverse prognosis of ischemic MR after acute coronary syndrome specially STEMI and just scarce studies address that effect after NSTEMI. We think that our study is the only one to choose patients documented to had no MR before NSTEMI. This will add the importance to strongly handle any MR after acute coronary syndrome with careful attention to help decision making.