title: Prognostic significance of mitral regurgitation in long-term all-cause mortality in patients aged ≥ 80 years with acute coronary syndrome.
abstract: BACKGROUND
  Mitral regurgitation (MR) has been shown to be associated with a poor prognosis in the patients with acute myocardial infarction, whether or not percutaneous coronary intervention (PCI) is employed. However, the long-term prognostic significance of MR in octogenarian patients with acute coronary syndrome (ACS) remains unknown. We sought to determine the impact of MR on long-term all-cause mortality and to further reveal whether PCI could influence the prognosis in octogenarian MR patients with ACS.
  
  
  METHODS
  In this study, we included a total of 353 consecutive hospitalized patients, aged ≥ 80 years, with ACS during the period of 5-year follow-up. Association between MR and long-term all-cause mortality was analyzed both in a overall cohort and in a matched cohort developed from a propensity score analysis.
  
  
  RESULTS
  MR was independently associated with long-term all-cause mortality in the overall and matched cohorts (hazard ratio (HR) 1.58, 95% CI 1.01-2.47, P=0.043; HR 1.90, 95% CI 1.15-3.13, P=0.013). In the subgroup treated with PCI, MR also exhibited higher long-term all-cause mortality, PCI remained an independent determinant of improving long-term survival rate by reducing the mortality by 15.1% in ACS patients with MR aged ≥ 80 years.
  
  
  CONCLUSIONS
  Our study demonstrates that MR is independently associated with long-term all-cause mortality, and PCI is an independent determinant for improving the long-term survival rate in the octogenarian ACS patients with MR.
authors.affiliation: Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital/Östra Hospital, Gothenburg, Sweden; Section of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Shijun
authors.initials: S
authors.lastname: Li
authors.affiliation: Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital/Östra Hospital, Gothenburg, Sweden.
authors.forename: Salim
authors.initials: S
authors.lastname: Barywani
authors.affiliation: Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital/Östra Hospital, Gothenburg, Sweden. Electronic address: Michael.Fu@wlab.gu.se.
authors.forename: Michael
authors.initials: M
authors.lastname: Fu
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000401:mortality*; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000175:diagnosis* / Q000401:mortality*; D011379:Prognosis; D013997:Time Factors
keywords: Acute coronary syndrome; All-cause mortality; Mitral regurgitation; Very elderly