A STUDY OF MITRAL REGURGITATION AND ITS ASSOCIATION WITH NON-ST ELEVATION MYOCARDIAL INFARCTION

ZAKIR HUSSAIN G; NAGESHWARAN; SWAMINATHAN N; VENKATESAN S

Volume : VII, Issue : VII, July - 2018

A STUDY OF MITRAL REGURGITATION AND ITS ASSOCIATION WITH NON-ST ELEVATION MYOCARDIAL INFARCTION

Zakir Hussain G, Nageshwaran, Swaminathan N, Venkatesan S

Abstract :

INTRODUCTION: 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 clinical, angiographic profile and short–term prognostic implications of MR in patients with NSTEMI.

METHODS: The study was done in 52 patients during a period of one year who had MR with NSTEMI. Each underwent echocardiography during the hospital course, and patients were followed up clinically for a median of 1month. The incidence for heart failure, reinfarction and death was recorded.

RESULTS: The patients mean age was 58.23 years and 73% patients were male. Among the study population, 22 had diabetes mellitus, 22 had hypertension, four patients had chronic kidney disease, and four had past history of coronary artery disease. 44 patients had ECG changes in the form of ST–T changes. Majority of patients with mild MR had normal ejection fraction (EF). Among patients with moderate MR, 8 had EF between 41–55%. Patient with severe MR had EF between 31– 40%. The incidence of MR were mild MR in 40 patients, moderate MR in 10 patients and severe in 2 patients. 8 patients had significant left main coronary artery disease, 38 patients had significant left anterior descendingartery disease, 44 patients had left circumflexartery disease, and 34 patients had right coronary artery disease. 32 patients had triple vessel disease, 14 pateintshad double vessel disease, and 6 patients had single vessel disease. 26 patients were advised bypass surgery, 12 patients had multivesselpercutaneous intervention. One patient died during hospital course.

CONCLUSIONS: In this study, presence of MR together with other unfavourable factors had a poor prognosis. This is also true for milder grades of MR. Severity of MR may affect prognosis, which requires further validation. Consequently, MR should be fully assessed and followed–up after NSTEMI in all patients.