Prognostic implication of tricuspid regurgitation in st-segment elevation myocardial infarction patients

Ben Sadeh, Tamar Itach, Ilan Merdler, Shir Frydman, Samuel Morgan, David Zahler, Yogev Peri, Aviram Hochstadt, Yotam Pasternak, Yan Topilsky, Shmuel Banai, Yacov Shacham

Research output: Contribution to journalArticlepeer-review

Abstract

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: To investigate the possible implication of TR among STEMI patients. 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 as well as the 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: 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 (2.44, 95% confidence interval 1.06-5.6, P = .036) for patients with moderate to severe TR. Conclusions: Among STEMI patients after primary PCI, the presence of moderate to severe TR was independently associated with adverse outcomes and significantly lower survival rate.

Original languageEnglish
Pages (from-to)441-446
Number of pages6
JournalIsrael Medical Association Journal
Volume23
Issue number7
StatePublished - Jul 2021

Keywords

  • Echocardiography
  • Percutaneous coronary intervention (PCI)
  • ST-segment elevation myocardial infarction (STEMI)
  • Tricuspid regurgitation (TR)

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