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The impact of pre-existing aortic stenosis and mitral regurgitation on patients with acute myocardial infarction

Z. Motovska, T. Muzafarova, P. Kala, O. Hlinomaz, M. Hromadka, T. Vichova, J. Mrozek, M. Šramko, M. Hutyra, R. Petr, P. Tomasov, O. Ionita, PL. Santi, AP. Chua, J. Jarkovsky

. 2025 ; 15 (1) : 17449. [pub] 20250520

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc25015698

The prevalence of left-sided valvular heart disease (VHD) increases with age, but data on the impact of pre-existing VHD in patients with acute myocardial infarction (AMI) are limited. We aimed to define the clinical characteristics and outcomes of AMI patients with pre-existing left VHD. The analysis is based on data from three merged national registries. The dataset included 47,436 patients admitted with AMI over a 5year period at all Cath Labs nationwide. Pre-existing VHD was diagnosed in 1,445 patients (3.0%), moderate-to-severe mitral regurgitation (MR) in 510 patients (35.3%), and moderate-to-severe aortic stenosis (AS) in 869 patients (60.1%). Patients with VHD had worse baseline characteristics, pre-existing coronary artery disease, more complicated in-hospital course with higher Killip class, lower left ventricular ejection fraction, and more comorbidities. Angiographically more frequent left main stenosis, TIMI flow 3 before PCI, less frequent stent implantation. Patients with pre-existing VHD had significantly higher 7-day (10.1% vs. 4.5%, p < 0.001), 30-day (16.0% vs. 7.0%, p < 0.001) and 1-year mortality (28.7 vs. 12.7%, p < 0.001) compared to patients without. Conclusions. Patients with pre-existing VHD and AMI are characterized by complicated in-hospital course with higher Killip class, lower ejection fraction, angiographically less severe stenosis, TIMI flow 3 prior to PCI, and less frequent stent implantation. This is a high-risk group with higher short - and long-term mortality and earlier intervention should be considered.

Citace poskytuje Crossref.org

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$a The impact of pre-existing aortic stenosis and mitral regurgitation on patients with acute myocardial infarction / $c Z. Motovska, T. Muzafarova, P. Kala, O. Hlinomaz, M. Hromadka, T. Vichova, J. Mrozek, M. Šramko, M. Hutyra, R. Petr, P. Tomasov, O. Ionita, PL. Santi, AP. Chua, J. Jarkovsky
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$a The prevalence of left-sided valvular heart disease (VHD) increases with age, but data on the impact of pre-existing VHD in patients with acute myocardial infarction (AMI) are limited. We aimed to define the clinical characteristics and outcomes of AMI patients with pre-existing left VHD. The analysis is based on data from three merged national registries. The dataset included 47,436 patients admitted with AMI over a 5year period at all Cath Labs nationwide. Pre-existing VHD was diagnosed in 1,445 patients (3.0%), moderate-to-severe mitral regurgitation (MR) in 510 patients (35.3%), and moderate-to-severe aortic stenosis (AS) in 869 patients (60.1%). Patients with VHD had worse baseline characteristics, pre-existing coronary artery disease, more complicated in-hospital course with higher Killip class, lower left ventricular ejection fraction, and more comorbidities. Angiographically more frequent left main stenosis, TIMI flow 3 before PCI, less frequent stent implantation. Patients with pre-existing VHD had significantly higher 7-day (10.1% vs. 4.5%, p < 0.001), 30-day (16.0% vs. 7.0%, p < 0.001) and 1-year mortality (28.7 vs. 12.7%, p < 0.001) compared to patients without. Conclusions. Patients with pre-existing VHD and AMI are characterized by complicated in-hospital course with higher Killip class, lower ejection fraction, angiographically less severe stenosis, TIMI flow 3 prior to PCI, and less frequent stent implantation. This is a high-risk group with higher short - and long-term mortality and earlier intervention should be considered.
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$a Kala, Petr $u Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic
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$a Hlinomaz, Ota $u First Department of Internal Medicine - Cardioangiology ICRC Faculty of Medicine of Masaryk, University and St. Anne's University Hospital, Brno, Czech Republic
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$a Mrozek, Jan $u Cardiovascular Department University Hospital Ostrava, Ostrava, Czech Republic
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$a Šramko, Marek $u Department of Cardiology Institute for Clinical and Experimental Medicine, Olomouc, Czech Republic
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$a Petr, Robert $u Cardiology Prague Ltd, Prague, Czech Republic
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$a Tomasov, Pavol $u Liberec Regional Hospital, Liberec, Czech Republic
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$a Santi, Pilar Lopez $u Leiden University Medical Centre, Leiden, Netherlands
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$a Chua, Aileen Paula $u Leiden University Medical Centre, Leiden, Netherlands
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