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DECLINING IMPACT OF ISCHEMIC MITRAL REGURGITATION ON LONG TERM MORTALITY FOLLOWING PRIMARY PERCUTANEOUS CORONARY INTERVENTION
445 JACC April 5, 2016 Volume 67, Issue 13
Acute Coronary Syndromes DECLINING IMPACT OF ISCHEMIC MITRAL REGURGITATION ON LONG TERM MORTALITY FOLLOWING PRIMARY PERCUTANEOUS CORONARY INTERVENTION Moderated Poster Contributions Acute Coronary Syndromes Moderated Poster Theater, Poster Area, South Hall A1 Saturday, April 02, 2016, 11:45 a.m.-11:55 a.m. Session Title: Prognosticating: Who Will Do Better and Who Will Do Worse in ACS Abstract Category: 14. Acute Coronary Syndromes: Clinical Presentation Number: 1121M-15 Authors: Amgad G. Mentias, Mohammad Q. Raza, Amr F. Barakat, Elizabeth Hill, Brian Griffin, Stephen Ellis, Venu Menon, E. Murat Tuzcu, Samir Kapadia, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA Background: Ischemic mitral regurgitation (IMR) is an established complication of ST elevation myocardial infarction (STEMI). We studied the change in incidence and outcomes of IMR in the past 20 years in a tertiary center.
Methods: Amongst 3914 patients undergoing primary percutaneous coronary intervention within 12 hours of presentation with STEMI to our center from 1995-2014, 792 (20.2%) had IMR on their baseline echo performed within 3 days. We evaluated the impact of IMR on short and long term mortality over 2 decades. Results: The median door to balloon time decreased over the study period (238, 199, 162 and 40 minutes, p<0.01 for the 4 time periods). We observed a corresponding decreases in the incidence of IMR (28.5, 28.4, 19.4, 9% p<0.05). The mean age, sex, % diabetes mellitus, obesity, ejection fraction, shock on presentation and location of STEMI were similar across grades of observed MR over time. Short and long-term mortality with each grade of IMR across the four time periods are shown in the Figure. Conclusions: With decreasing door to balloon and total ischemic time, the incidence of ischemic mitral regurgitation has decreased over time. Although worsening mitral regurgitation remains associated with high long term mortality, the 3 year prognosis of ischemic mitral regurgitation regardless of grade has dramatically improved over time.
Acute Coronary Syndromes DECLINING IMPACT OF ISCHEMIC MITRAL REGURGITATION ON LONG TERM MORTALITY FOLLOWING PRIMARY PERCUTANEOUS CORONARY INTERVENTION Moderated Poster Contributions Acute Coronary Syndromes Moderated Poster Theater, Poster Area, South Hall A1 Saturday, April 02, 2016, 11:45 a.m.-11:55 a.m. Session Title: Prognosticating: Who Will Do Better and Who Will Do Worse in ACS Abstract Category: 14. Acute Coronary Syndromes: Clinical Presentation Number: 1121M-15 Authors: Amgad G. Mentias, Mohammad Q. Raza, Amr F. Barakat, Elizabeth Hill, Brian Griffin, Stephen Ellis, Venu Menon, E. Murat Tuzcu, Samir Kapadia, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA Background: Ischemic mitral regurgitation (IMR) is an established complication of ST elevation myocardial infarction (STEMI). We studied the change in incidence and outcomes of IMR in the past 20 years in a tertiary center.
Methods: Amongst 3914 patients undergoing primary percutaneous coronary intervention within 12 hours of presentation with STEMI to our center from 1995-2014, 792 (20.2%) had IMR on their baseline echo performed within 3 days. We evaluated the impact of IMR on short and long term mortality over 2 decades. Results: The median door to balloon time decreased over the study period (238, 199, 162 and 40 minutes, p<0.01 for the 4 time periods). We observed a corresponding decreases in the incidence of IMR (28.5, 28.4, 19.4, 9% p<0.05). The mean age, sex, % diabetes mellitus, obesity, ejection fraction, shock on presentation and location of STEMI were similar across grades of observed MR over time. Short and long-term mortality with each grade of IMR across the four time periods are shown in the Figure. Conclusions: With decreasing door to balloon and total ischemic time, the incidence of ischemic mitral regurgitation has decreased over time. Although worsening mitral regurgitation remains associated with high long term mortality, the 3 year prognosis of ischemic mitral regurgitation regardless of grade has dramatically improved over time.