In-Hospital Mortality in Patients With Acute ST-Elevation Myocardial Infarction With or Without Mitral Regurgitation.

Area of Science:

• Cardiology
• Cardiac Surgery
• Internal Medicine

Background:

• Mitral regurgitation (MR) is a frequent complication in hospitalized patients with ST-elevation myocardial infarction (STEMI).
• Patient outcomes in STEMI with MR vary significantly, necessitating risk stratification for in-hospital mortality.
• There is a need to understand the impact of MR on mortality in STEMI patients within specific healthcare settings.

Purpose of the Study:

• To compare the in-hospital mortality rates of STEMI patients with and without MR.
• To identify factors associated with MR in STEMI patients.
• To assess the prognostic value of MR in STEMI.

Main Methods:

• Prospective study comparing mortality in STEMI patients with and without MR.
• Enrollment of all STEMI patients treated at Lady Reading Hospital (LRH) from June 5 to October 30, 2021.
• Confirmation of ST-elevation via ECG and MR via echocardiography; exclusion of primary valve disease or congenital heart disease.

Main Results:

• The study included 228 STEMI patients (mean age 62.4 ± 12.3 years; 61.4% male).
• Prevalence of MR was 29.4%; hypertension (63.6%) was the most common comorbidity.
• In-hospital mortality was 29.8%, significantly associated with MR (p=.0001), prehospital CPR, and Killip class ≥ 2.

Conclusions:

• MR is prevalent in STEMI, particularly in inferior wall MI.
• STEMI patients with MR exhibit a poorer prognosis, especially with co-existing comorbidities.
• Assessing MR is essential for treatment decisions in STEMI patients to improve outcomes.