PMID- 27933193
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210112
IS  - 2053-3624 (Print)
IS  - 2053-3624 (Electronic)
IS  - 2053-3624 (Linking)
VI  - 3
IP  - 2
DP  - 2016
TI  - Outcomes of ischaemic mitral regurgitation in anterior versus inferior ST 
      elevation myocardial infarction.
PG  - e000493
LID - e000493
AB  - BACKGROUND: Ischaemic mitral regurgitation (IMR) is a detrimental complication of 
      ST elevation myocardial infarction (STEMI). OBJECTIVE: We sought to determine 
      patient characteristics and outcomes of patients with IMR with focus on anterior 
      or inferior location of STEMI. METHODS: All patients presenting with STEMI 
      complicated by IMR to our centre who underwent primary percutaneous coronary 
      intervention within the first 12 hours of presentation from 1995 to 2014 were 
      included. IMR was graded from 1+ to 4+ within 3 days of index myocardial 
      infarction by echocardiography, divided into 2 groups based on infarct location 
      and outcomes were compared. RESULTS: Overall, 805 patients were included. There 
      were 302 (17.8%) patients with mitral regurgitation (MR) out of the 1700 patients 
      with anterior STEMI while 503 (21.8%) had MR out of the 2305 patients with 
      inferior STEMI. There was no significant difference between both groups in 
      comorbidities, clinical presentation or door-to-balloon time (DBT; median 104 vs 
      106 min, p=0.5). 30-day and 1-year mortality were higher in anterior STEMI 
      compared with inferior STEMI (14.9% vs 6.8% and 26.4% vs 14.3%, respectively, 
      p<0.001 both), as well as 5-year mortality (39.7% vs 24.8%, p<0.01). When 
      analysis was performed for each grade of IMR, anterior was associated with worse 
      outcomes in every grade. On multivariate cox survival analysis, after adjustment 
      for age, gender, comorbidities, grade of IMR, ejection fraction and DBT, anterior 
      STEMI was still associated with worse outcomes (HR 1.62 (95% CI 1.23 to 2.12), 
      p<0.001). CONCLUSIONS: Although IMR occurs more frequently with inferior 
      infarction, outcomes are worse following anterior infarction.
FAU - Mentias, Amgad
AU  - Mentias A
AD  - Heart and Vascular Institute, Cleveland Clinic , Cleveland, Ohio , USA.
FAU - Raza, Mohammad Q
AU  - Raza MQ
AD  - Heart and Vascular Institute, Cleveland Clinic , Cleveland, Ohio , USA.
FAU - Barakat, Amr F
AU  - Barakat AF
AD  - Heart and Vascular Institute, Cleveland Clinic , Cleveland, Ohio , USA.
FAU - Hill, Elizabeth
AU  - Hill E
AD  - Heart and Vascular Institute, Cleveland Clinic , Cleveland, Ohio , USA.
FAU - Youssef, Dalia
AU  - Youssef D
AD  - Heart and Vascular Institute, Cleveland Clinic , Cleveland, Ohio , USA.
FAU - Krishnaswamy, Amar
AU  - Krishnaswamy A
AD  - Heart and Vascular Institute, Cleveland Clinic , Cleveland, Ohio , USA.
FAU - Desai, Milind Y
AU  - Desai MY
AD  - Heart and Vascular Institute, Cleveland Clinic , Cleveland, Ohio , USA.
FAU - Griffin, Brian
AU  - Griffin B
AD  - Heart and Vascular Institute, Cleveland Clinic , Cleveland, Ohio , USA.
FAU - Ellis, Stephen
AU  - Ellis S
AD  - Heart and Vascular Institute, Cleveland Clinic , Cleveland, Ohio , USA.
FAU - Menon, Venu
AU  - Menon V
AD  - Heart and Vascular Institute, Cleveland Clinic , Cleveland, Ohio , USA.
FAU - Tuzcu, E Murat
AU  - Tuzcu EM
AD  - Heart and Vascular Institute, Cleveland Clinic , Cleveland, Ohio , USA.
FAU - Kapadia, Samir R
AU  - Kapadia SR
AD  - Heart and Vascular Institute, Cleveland Clinic , Cleveland, Ohio , USA.
LA  - eng
PT  - Journal Article
DEP - 20161110
PL  - England
TA  - Open Heart
JT  - Open heart
JID - 101631219
PMC - PMC5128765
COIS- Conflicts of Interest: None declared.
EDAT- 2016/12/10 06:00
MHDA- 2016/12/10 06:01
PMCR- 2016/11/10
CRDT- 2016/12/10 06:00
PHST- 2016/07/03 00:00 [received]
PHST- 2016/08/15 00:00 [revised]
PHST- 2016/08/22 00:00 [accepted]
PHST- 2016/12/10 06:00 [entrez]
PHST- 2016/12/10 06:00 [pubmed]
PHST- 2016/12/10 06:01 [medline]
PHST- 2016/11/10 00:00 [pmc-release]
AID - openhrt-2016-000493 [pii]
AID - 10.1136/openhrt-2016-000493 [doi]
PST - epublish
SO  - Open Heart. 2016 Nov 10;3(2):e000493. doi: 10.1136/openhrt-2016-000493. 
      eCollection 2016.