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Outcomes of patients with ischemic mitral regurgitation undergoing percutaneous coronary intervention

Rayan Yousefzai1, Navkaranbir Bajaj1, Amar Krishnaswamy2

  • 1Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.

The American Journal of Cardiology
|August 14, 2014
PubMed

Insights

Percutaneous coronary intervention (PCI) alone improved ischemic mitral regurgitation (IMR) in 36.5% of patients. This improvement correlated with reduced left ventricular size and increased ejection fraction, suggesting PCI benefits for IMR patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Ischemic mitral regurgitation (IMR) is linked to adverse outcomes in coronary artery disease patients.
  • The effect of percutaneous coronary intervention (PCI) on IMR is not fully understood.

Purpose of the Study:

  • To evaluate the outcomes of patients with severe IMR undergoing PCI.
  • To identify predictors of IMR improvement after PCI.

Main Methods:

  • Retrospective analysis of 137 patients with severe (≥3+) IMR who underwent PCI between 1998 and 2010.
  • Improvement defined as reduction in IMR severity to ≤2+ solely with PCI.
  • Comparison of outcomes between patients with and without IMR improvement.

Main Results:

  • 36.5% of patients experienced IMR improvement with PCI alone; 18.5% required additional interventions.
  • Smaller left atrial size predicted IMR improvement (OR 0.39).
  • Patients with IMR improvement showed significant left ventricular reverse remodeling (decreased size, increased ejection fraction).

Conclusions:

  • PCI alone can improve IMR severity in a significant proportion of patients.
  • IMR improvement after PCI is associated with favorable left ventricular remodeling.
  • Left atrial size is a key predictor for IMR improvement post-PCI.

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