Document Detail


Ischemic mitral regurgitation and non-ST-segment elevation acute myocardial infarction: long-term prognosis.
MedLine Citation:
PMID:  19889338     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION AND OBJECTIVES: Ischemic mitral regurgitation (MR) is a common complication of acute myocardial infarction and has a negative impact on prognosis. However, few studies have been carried out on MR after non-ST-segment elevation acute myocardial infarction (NSTEMI). Our objective was to investigate the incidence, clinical predictors and long-term prognostic implications of MR in patients with NSTEMI. METHODS: The prospective study included 237 consecutive patients who were discharged in functional class I or II after a first NSTEMI. Each underwent echocardiography during the first week of admission, and patients were followed up clinically for a median of 1011 days. The incidence of readmission for heart failure, unstable angina, reinfarction, death or all combined (i.e. the combined event or major adverse cardiac event [MACE]) was recorded. RESULTS: The patients' mean age was 66+/-13 years and 74% were male. The incidence of MR was 40% (grade I in 71 patients, grade II in 15, grade III in 6, and grade IV in 3). Age, diabetes mellitus, multivessel disease and MR (HR=2.17; 95% confidence interval 1.30-3.64; P=.003) were all independently associated with a poor long-term prognosis, in terms of MACEs. Even the milder grades of MR were associated with more events. CONCLUSIONS: In our milieu, MR frequently occurs after NSTEMI. Its presence together with other unfavorable factors implies a poor long-term prognosis. This is also true for milder grades of MR. Consequently, MR should be fully assessed and followed-up after NSTEMI in all patients.
Authors:
Iv?n Javier N??ez Gil; Leopoldo P?rez de Isla; Juan Carlos Garc?a-Rubira; Antonio Fern?ndez-Ortiz; Juan Jos? Gonz?lez Ferrer; David Vivas; Jos? Alberto de Agust?n Loeches; Carlos Macaya; Jos? Zamorano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Revista espa?ola de cardiolog?a     Volume:  62     ISSN:  1579-2242     ISO Abbreviation:  Rev Esp Cardiol     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-05     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404277     Medline TA:  Rev Esp Cardiol     Country:  Spain    
Other Details:
Languages:  eng     Pagination:  1267-75     Citation Subset:  IM    
Affiliation:
Servicio de Cardiolog?a, Hospital Cl?nico San Carlos, Madrid, Spain. ibnsky@yahoo.es
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Follow-Up Studies
Humans
Male
Middle Aged
Mitral Valve Insufficiency / epidemiology,  etiology*
Myocardial Infarction / complications*,  physiopathology
Prognosis
Prospective Studies
Time Factors

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