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Mitral Regurgitation Following Acute Myocardial Infarction Treated by Percutaneous Coronary Intervention-Prevalence,

Harish Sharma1, Ashwin Radhakrishnan1, Peter Nightingale2

  • 1Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom; Department of Cardiology, University Hospitals Birmingham, Birmingham, United Kingdom.

The American Journal of Cardiology
|August 21, 2021
PubMed

Insights

Mitral regurgitation (MR) after acute myocardial infarction (AMI) affects over a quarter of patients and is linked to worse survival, even in mild cases. Risk factors include older age and reduced left ventricular ejection fraction.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Echocardiography

Background:

  • Mitral regurgitation (MR) following acute myocardial infarction (AMI) is a known complication with significant prognostic implications.
  • Existing data on the prevalence and impact of MR post-AMI are varied, necessitating further investigation into risk factors and outcomes.

Purpose of the Study:

  • To determine the prevalence of mitral regurgitation in patients following acute myocardial infarction.
  • To identify risk factors associated with the development of MR post-AMI.
  • To evaluate the impact of MR on patient outcomes and mortality.

Main Methods:

  • A cohort of 1000 consecutive patients admitted with AMI between 2016-2017 were analyzed.
  • Transthoracic echocardiography was performed pre-discharge to assess for MR.
  • Patient demographics, clinical history, AMI characteristics, treatment details, and long-term mortality data were collected and analyzed.

Main Results:

  • Mitral regurgitation was present in 29% of patients (294/1000), predominantly mild (76%).
  • Patients with MR were older, had worse left ventricular ejection fraction (LVEF), and reduced creatinine clearance.
  • Higher rates of hypertension, heart failure, previous MI, and severe coronary artery disease were observed in patients with MR. Delayed revascularization (>72 hours) was associated with increased MR likelihood in NSTEMI patients. Even mild MR was linked to increased mortality over a mean follow-up of 3.2 years.

Conclusions:

  • Mitral regurgitation is a common complication after AMI, affecting over a quarter of patients.
  • The presence of MR, even when mild, is independently associated with increased mortality post-AMI.
  • Risk factors include older age, reduced LVEF, and delayed revascularization in NSTEMI, highlighting the need for early detection and management.

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