title: Primary reperfusion in acute right ventricular infarction: An observational study.
abstract: OBJECTIVE
  To investigate the impact of primary reperfusion therapy (RT) on early and late mortality in acute right ventricular infarction (RVI).
  
  
  METHODS
  RVI patients (n = 679) were prospectively classified as without right ventricular failure (RVF) (class A, n = 425, 64%), with RVF (class B, n = 158, 24%) or with cardiogenic shock (CS) (class C, n = 96, 12%). Of the 679 patients, 148 (21.7%) were considered to be eligible for thrombolytic therapy (TT) and 351 (51.6%) for primary percutaneous coronary intervention (PPCI). TIMI 3-flow by TT was achieved for A, B and C RVI class in 65%, 64% and 0%, respectively and with PPCI in 93%, 91% and 87%, respectively.
  
  
  RESULTS
  For class A without RT, the mortality rate was 7.9%, with TT was reduced to 4.4% (P < 0.01) and with PPCI to 3.2% (P < 0.01). Considering TT vs PPCI, PPCI was superior (P < 0.05). For class B without RT the mortality was 27%, decreased to 13% with TT (P < 0.01) and to 8.3% with PPCI (P < 0.01). In a TT and PPCI comparison, PPCI was superior (P < 0.01). For class C without RT the in-hospital mortality was 80%, with TT was 100% and with PPCI, the rate decreased to 44% (P < 0.01). At 8 years, the mortality rate without RT for class A was 32%, for class B was 48% and for class C was 85%. When PPCI was successful, the long-term mortality was lower than previously reported for the 3 RVI classes (A: 21%, B: 38%, C: 70%; P < 0.001).
  
  
  CONCLUSIONS
  PPCI is superior to TT and reduces short/long-term mortality for all RVI categories. RVI CS patients should be encouraged to undergo PPCI at a specialized center.
authors: Eulo Lupi-Herrera, The American British Cowdray Medical Center I.A.P., Mexico City 14080, Mexico.
authors: Eulo
authors: E
authors: Lupi-Herrera
authors: Eulo Lupi-Herrera, The American British Cowdray Medical Center I.A.P., Mexico City 14080, Mexico.
authors: Héctor
authors: H
authors: González-Pacheco
authors: Eulo Lupi-Herrera, The American British Cowdray Medical Center I.A.P., Mexico City 14080, Mexico.
authors: Ursulo
authors: U
authors: Juárez-Herrera
authors: Eulo Lupi-Herrera, The American British Cowdray Medical Center I.A.P., Mexico City 14080, Mexico.
authors: Nilda
authors: N
authors: Espinola-Zavaleta
authors: Eulo Lupi-Herrera, The American British Cowdray Medical Center I.A.P., Mexico City 14080, Mexico.
authors: Eduardo
authors: E
authors: Chuquiure-Valenzuela
authors: Eulo Lupi-Herrera, The American British Cowdray Medical Center I.A.P., Mexico City 14080, Mexico.
authors: Ramón
authors: R
authors: Villavicencio-Fernández
authors: Eulo Lupi-Herrera, The American British Cowdray Medical Center I.A.P., Mexico City 14080, Mexico.
authors: Marco Antonio
authors: MA
authors: Peña-Duque
authors: Eulo Lupi-Herrera, The American British Cowdray Medical Center I.A.P., Mexico City 14080, Mexico.
authors: Ernesto
authors: E
authors: Ban-Hayashi
authors: Eulo Lupi-Herrera, The American British Cowdray Medical Center I.A.P., Mexico City 14080, Mexico.
authors: Sergio
authors: S
authors: Férez-Santander
keywords: Cardiogenic shock; Morbidity; Mortality; Reperfusion therapy; Right ventricular infarction; Ventricular failure