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The influence of severe mitral regurgitation on major adverse cardiac and cerebrovascular events after myocardial infarction in 1-year follow-up: Data from PL-ACS registry

Szymon Ładziński1, Jacek Niedziela2, Adam Witkowski3, Stanisław Bartuś4, Maciej Lesiak5, Krzysztof Milewski6, Marek Gierlotka7, Przemysław Trzeciak2, Mariusz Gąsior2, Wojciech Wojakowski1
DOI: 10.33963/KP.a2023.0064
·
Pubmed: 36929297
Affiliations
  1. Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
  2. 3rd Department of Cardiology, Silesian Center for Heart Diseases, Medical University of Silesia, Katowice, Poland
  3. Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
  4. 2nd Department of Cardiology, Medical College, Jagiellonian University, Kraków, Poland
  5. Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
  6. Research and Development Center, American Heart of Poland, Warszawa, Poland
  7. Department of Cardiology, Faculty of Medicine, University of Opole, Opole, Poland

open access

Online first
Original article
Published online: 2023-03-09

Abstract

Background: Mitral regurgitation (MR) is frequently observed in patients with myocardial infarction (MI). However, the incidence of severe MR in contemporary population is unknown.

Aims: The study evaluates the prevalence and prognostic impact of severe MR in contemporary population of patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI).

Methods: The study group consists of 8062 patients enrolled in the Polish Registry of Acute Coronary Syndromes over the years 2017‒2019. Only the patients with full echocardiography performed during the index hospitalization were eligible. Primary composite outcome was 12-month major adverse cardiac and cerebrovascular events (MACCE) (death, non-fatal MI, stroke and heart failure [HF] hospitalization) compared between patients with and without severe MR.

Results: 5561 NSTEMI patients and 2501 STEMI patients were enrolled into the study. Severe MR occurred in 66 (1.19%) NSTEMI patients and 30 (1.19%) STEMI patients. Multivariable regression models revealed that severe MR is an independent risk factor of all-cause death in 12-month observation (odds ratio [OR], 1.839; 95% confidence interval [CI], 1.012‒3.343; P = 0.046) in all MI patients. Patients with NSTEMI and severe MR had higher mortality (22.7% vs. 7.1%), HF rehospitalization rate (39.4% vs. 12.9%) and MACCE occurrence (54.5% vs. 29.3%). Severe MR was associated with higher mortality (20% vs. 6%) and higher HF rehospitalization (30% vs. 9.8%), stroke (10% vs. 0.8%) and MACCE rates (50% vs. 23.1%) in STEMI patients.

Conclusions: Severe MR is associated with higher mortality and MACCE occurrence in patients with MI in 12-month follow-up. Severe MR is an independent risk factor of all-cause death.

Abstract

Background: Mitral regurgitation (MR) is frequently observed in patients with myocardial infarction (MI). However, the incidence of severe MR in contemporary population is unknown.

Aims: The study evaluates the prevalence and prognostic impact of severe MR in contemporary population of patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI).

Methods: The study group consists of 8062 patients enrolled in the Polish Registry of Acute Coronary Syndromes over the years 2017‒2019. Only the patients with full echocardiography performed during the index hospitalization were eligible. Primary composite outcome was 12-month major adverse cardiac and cerebrovascular events (MACCE) (death, non-fatal MI, stroke and heart failure [HF] hospitalization) compared between patients with and without severe MR.

Results: 5561 NSTEMI patients and 2501 STEMI patients were enrolled into the study. Severe MR occurred in 66 (1.19%) NSTEMI patients and 30 (1.19%) STEMI patients. Multivariable regression models revealed that severe MR is an independent risk factor of all-cause death in 12-month observation (odds ratio [OR], 1.839; 95% confidence interval [CI], 1.012‒3.343; P = 0.046) in all MI patients. Patients with NSTEMI and severe MR had higher mortality (22.7% vs. 7.1%), HF rehospitalization rate (39.4% vs. 12.9%) and MACCE occurrence (54.5% vs. 29.3%). Severe MR was associated with higher mortality (20% vs. 6%) and higher HF rehospitalization (30% vs. 9.8%), stroke (10% vs. 0.8%) and MACCE rates (50% vs. 23.1%) in STEMI patients.

Conclusions: Severe MR is associated with higher mortality and MACCE occurrence in patients with MI in 12-month follow-up. Severe MR is an independent risk factor of all-cause death.

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Keywords

mitral regurgitation, mortality, myocardial infarction

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Title

The influence of severe mitral regurgitation on major adverse cardiac and cerebrovascular events after myocardial infarction in 1-year follow-up: Data from PL-ACS registry

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2023-03-09

Page views

14

Article views/downloads

15

DOI

10.33963/KP.a2023.0064

Pubmed

36929297

Keywords

mitral regurgitation
mortality
myocardial infarction

Authors

Szymon Ładziński
Jacek Niedziela
Adam Witkowski
Stanisław Bartuś
Maciej Lesiak
Krzysztof Milewski
Marek Gierlotka
Przemysław Trzeciak
Mariusz Gąsior
Wojciech Wojakowski

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