title: Prognostic significance of functional mitral regurgitation after a first non-ST-segment elevation acute coronary syndrome.
abstract: OBJECTIVE
  The development of mitral regurgitation (MR) after an acute myocardial infarction (AMI) is a recognized and frequent complication and its negative impact on survival has been observed. However, few data exist regarding MR after non-ST-segment elevation acute coronary syndrome (NSTSEACS). Our aim was to investigate the incidence, clinical predictors, and prognostic implications of MR in the setting of NSTSEACS.
  
  
  RESULTS
  We studied 300 consecutive patients (71.7% men, mean age 66.9+/-13 years) admitted to our coronary care unit for an NSTSEACS. Every patient underwent an echocardiographic study during the first week after the index NSTSEACS and was clinically followed up. MR was detected in 42% (126 patients; 88 men, mean age 71.3+/-11 years). Mean follow-up was 425.6+/-194.8 days. Only age and left ventricular (LV) ejection fraction (EF) were found as independent markers of the development of MR; no variable was found as an independent predictor of in-hospital mortality and only MR was found as an independent predictor of long-term outcome.
  
  
  CONCLUSIONS
  MR is frequent after an NSTSEACS. Age and a low LV EF are factors associated to its development. The presence and degree of MR confer a worse long-term prognosis to patients after a first NSTSEACS. Thus, the presence of MR should be specifically assessed in every patient after an NSTSEACS.
authors.affiliation: Instituto Cardiovascular, Echocardiographic Laboratory, Hospital Clínico San Carlos, Plaza Cristo Rey, 28040 Madrid, Spain.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Perez de Isla
authors.forename: Jose
authors.initials: J
authors.lastname: Zamorano
authors.forename: Maribel
authors.initials: M
authors.lastname: Quezada
authors.forename: Carlos
authors.initials: C
authors.lastname: Almería
authors.forename: José Luis
authors.initials: JL
authors.lastname: Rodrigo
authors.forename: Viviana
authors.initials: V
authors.lastname: Serra
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: García Rubira
authors.forename: Antonio Fernandez
authors.initials: AF
authors.lastname: Ortiz
authors.forename: Carlos
authors.initials: C
authors.lastname: Macaya
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology*; D009203:Myocardial Infarction / Q000150:complications*; D011379:Prognosis; D016019:Survival Analysis