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.

1st Department of Internal Medicine Cardioangiology ICRC Faculty of Medicine of Masaryk University and St Anne's University Hospital Brno Czech Republic

1st Internal Cardiology Clinic University Hospital Olomouc Olomouc Czech Republic

Cardiocentre 3rd Faculty of Medicine Charles University and University Hospital Kralovske Vinohrady Srobarova 50 Prague 10034 Czech Republic

Cardiology Prague Ltd Prague Czech Republic

Cardiovascular Department University Hospital Ostrava Ostrava Czech Republic

Department of Cardiology Faculty of Medicine in Pilsen University Hospital Charles University Pilsen Czech Republic

Department of Cardiology Institute for Clinical and Experimental Medicine Olomouc Czech Republic

Department of Internal Medicine and Cardiology Faculty of Medicine of Masaryk University and University Hospital Brno Brno Czech Republic

Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic

Leiden University Medical Centre Leiden Netherlands

Liberec Regional Hospital Liberec Czech Republic

The Institute of Health Information and Statistics of the Czech Republic Prague Czech Republic

Sci Rep. 2025 Aug 7;15(1):28903. doi: 10.1038/s41598-025-14530-x. PubMed

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