Prognostic Implication of Tricuspid Regurgitation in ST-segment Elevation Myocardial Infarction Patients.


Journal

The Israel Medical Association journal : IMAJ
ISSN: 1565-1088
Titre abrégé: Isr Med Assoc J
Pays: Israel
ID NLM: 100930740

Informations de publication

Date de publication:
Dec 2021
Historique:
entrez: 26 12 2021
pubmed: 27 12 2021
medline: 5 1 2022
Statut: ppublish

Résumé

Tricuspid regurgitation (TR) is associated with adverse prognosis in various patient populations, but currently no data is available about the prevalence and prognostic implication of TR in ST-segment elevation myocardial infarction (STEMI) patients. To investigate the possible implication of TR among STEMI patients. We conducted a retrospective study of STEMI patients undergoing primary percutaneous coronary intervention (PCI) and its relation to major clinical and echocardiographic parameters. Patient records were assessed for the prevalence and severity of TR, its relation to the clinical profile, key echocardiographic parameters, in-hospital outcomes, and long-term mortality. Patients with previous myocardial infarction or known previous TR were excluded. The study included 1071 STEMI patients admitted between September 2011 and May 2016 (age 61 ± 13 years; predominantly male). A total of 205 patients (19%) had mild TR while another 32 (3%) had moderate or greater TR. Patients with significant TR demonstrated worse echocardiographic parameters, were more likely to have in-hospital complications, and had higher long-term mortality (28% vs. 6%; P < 0.001). Following adjustment for significant clinical and echocardiographic parameters, mortality hazard ratio of at least moderate to severe TR remained significant (hazard ratio 2.44; 95% confidence interval 1.06-5.62; P = 0.036) for patients with moderate-severe TR. Among STEMI patients after primary PCI, the presence of moderate-severe TR was independently associated with adverse outcomes and significantly lower survival rate.

Sections du résumé

BACKGROUND BACKGROUND
Tricuspid regurgitation (TR) is associated with adverse prognosis in various patient populations, but currently no data is available about the prevalence and prognostic implication of TR in ST-segment elevation myocardial infarction (STEMI) patients.
OBJECTIVES OBJECTIVE
To investigate the possible implication of TR among STEMI patients.
METHODS METHODS
We conducted a retrospective study of STEMI patients undergoing primary percutaneous coronary intervention (PCI) and its relation to major clinical and echocardiographic parameters. Patient records were assessed for the prevalence and severity of TR, its relation to the clinical profile, key echocardiographic parameters, in-hospital outcomes, and long-term mortality. Patients with previous myocardial infarction or known previous TR were excluded.
RESULTS RESULTS
The study included 1071 STEMI patients admitted between September 2011 and May 2016 (age 61 ± 13 years; predominantly male). A total of 205 patients (19%) had mild TR while another 32 (3%) had moderate or greater TR. Patients with significant TR demonstrated worse echocardiographic parameters, were more likely to have in-hospital complications, and had higher long-term mortality (28% vs. 6%; P < 0.001). Following adjustment for significant clinical and echocardiographic parameters, mortality hazard ratio of at least moderate to severe TR remained significant (hazard ratio 2.44; 95% confidence interval 1.06-5.62; P = 0.036) for patients with moderate-severe TR.
CONCLUSIONS CONCLUSIONS
Among STEMI patients after primary PCI, the presence of moderate-severe TR was independently associated with adverse outcomes and significantly lower survival rate.

Identifiants

pubmed: 34954917

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

783-787

Auteurs

Ben Sadeh (B)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Tamar Itach (T)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Ilan Merdler (I)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Shir Frydman (S)

Department of Internal Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Samuel Morgan (S)

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

David Zahler (D)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Yogev Peri (Y)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Aviram Hochstadt (A)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Yotam Pasternak (Y)

Department of Internal Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Yan Topilsky (Y)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Shmuel Banai (S)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Yacov Shacham (Y)

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

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