Ischemic mitral regurgitation after acute coronary syndrome in the percutaneous coronary intervention Era (A registry from Tanta University Hospitals)

Abstract

Background: Acute coronary syndrome (ACS) represents a sign of coronary heart disease (CHD) that often results from plaque disruption in coronary arteries (atherosclerosis). Ischemic mitral regurgitation (IMR) stands as a common consequence among cases developing multivessel coronary artery disease. This work was aimed at characterizing the presentation, processes of care as well as outcomes for IMR cases following ACS. Methods: Our team conducted a Registry study including 358 cases who develop ACS (ST-elevation myocardial infarction (STEMI), non-STEMI or unstable angina (U.A)) undergoing revascularization for the culprit vessel using primary percutaneous coronary intervension (PPCI). Participants underwent a categorization into two groups: group I (n=124): ACS who developed IMR and group II (n=234): ACS who didn’t develop IMR. Results: Significant variations were documented among both groups regarding clinical presentations, angiographic findings and major adverse cardiac events (MACE). Also, a significant variation was observed among both types of cases regarding IMR severities and their improvements in the follow up visit (P=0.004) with certain factors predicting each of them. Conclusions: Systemic hypertension, dyslipidemia, extent of CAD, culprit vessel, door to balloon or total ischemic time were predictors to the incidence of IMR while complete revascularization and adherence to guideline directed medical therapy were predictors to its improvement.