Prognostic significance of ischemic mitral regurgitation after non-Q-wave acute myocardial infarction.
OBJECTIVE
The development of mitral regurgitation (MR) soon after acute myocardial infarction (AMI) is a recognized and frequent complication. Its negative impact on survival has been observed after Q-wave AMI, even when of a mild degree, and independently of left ventricular systolic function. Few data exist regarding MR after non-Q-wave AMI (nQ AMI), however. Hence, the study aim was to investigate the incidence, clinical predictors and prognostic implications of MR in the setting of nQ AMI.


RESULTS
A total of 99 consecutive patients (37 men, 62 women; mean age 72 +/- 13 years) who suffered a nQ AMI was studied. All patients underwent echocardiography during the first week after the nQ AMI. MR was detected in 34 patients (17 men, 17 women; mean age 76 +/- 10 years). Events during follow up were coded as death, AMI, unstable angina, or heart failure. The in-hospital outcome was not significantly different between patients with and without MR. The mean follow up period was 663 +/- 574 days. In the univariate analysis, freedom from hospital survival was significantly greater in patients without MR. However, multivariate analysis showed that MR was not an independent predictor of cardiovascular hospitalization or death.


CONCLUSIONS
The incidence of MR is high among patients with nQ AMI but, unlike results found with Q-wave AMI, its presence does not add any prognostic significance to other known negative factors in the setting of nQ AMI.
Perez de Isla
Leopoldo
L
Instituto Cardiovascular, Hospital Clinico San Carlos, Madrid, Spain.
Zamorano
Jose
J
Martinez Quesada
Mar
M
Corros
Cecilia
C
Ortiz
Pilar
P
Almeria
Carlos
C
Rodrigo
Jose Luis
JL
Aubele
Ada Lia
AL
Fernández-Ortiz
Antonio
A
Macaya
Carlos
C
D000368:Aged; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D013318:Stroke Volume; D015996:Survival Rate; D016277:Ventricular Function, Left