Document Detail

Mitral regurgitation is an independent predictor of 1-year mortality in ST-elevation myocardial infarction patients presenting in cardiogenic shock on admission.
MedLine Citation:
PMID:  20482326     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cardiogenic shock (CS) remains the most serious complication of acute ST-elevation myocardial infarction (STEMI). Mitral regurgitation (MR) is a frequent complication of STEMI and a well-known predictor of mortality in STEMI without CS. The purpose of this study was to determine the prognostic significance of MR in STEMI patients with CS on admission. METHODS: Mitral regurgitation was assessed in 147 consecutive STEMI patients with CS on admission and treated by primary percutaneous coronary intervention (PCI). Color Doppler of MR was graded with a 0 to 3 scale (none, n = 26; 1 = mild, n = 62; 2 = moderate, n = 40; 3 = severe, n = 19). RESULTS: Overall one-year mortality in the study cohort was 27%. One-year mortality was 8%, 23%, 30% and 58% for patients with no, mild, moderate and severe MR respectively (P <0.001). For each grade of MR increase, the odds for mortality increased with 71% (OR: 1.71; 95% CI: 1.02-2.87; P = 0.043) when adjusted for age, gender, previous myocardial infarction, left ventricular ejection fraction (LVEF) <40%, multivessel disease and no-reflow. CONCLUSIONS: The presence of MR on early echocardiography is an important independent predictor of one-year mortality in STEMI patients with CS on admission treated by primary PCI.
Annemarie E Engström; Marije M Vis; Berto J Bouma; Bimmer E P M Claessen; Krischan D Sjauw; Jan Baan; Martijn Meuwissen; Karel T Koch; Robbert J de Winter; Jan G P Tijssen; Jan J Piek; José P S Henriques
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acute cardiac care     Volume:  12     ISSN:  1748-295X     ISO Abbreviation:  Acute Card Care     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-20     Completed Date:  2010-08-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101276603     Medline TA:  Acute Card Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  51-7     Citation Subset:  IM    
Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands. <>
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Cohort Studies
Echocardiography, Doppler, Color
Emergency Service, Hospital
Middle Aged
Mitral Valve Insufficiency / complications,  diagnosis*,  mortality*
Predictive Value of Tests
Risk Factors
Severity of Illness Index
Shock, Cardiogenic / mortality*,  physiopathology*,  therapy
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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