Impact of concurrent right ventricular myocardial infarction on outcomes among patients with left ventricular myocardial infarction

Abstract

to compare in-hospital outcomes between left ventricular myocardial infarction (LVMi) patients with and without right ventricular myocardial infarction (RVMi). patients with acute St-segment elevation Mi (SteMi) undergoing primary percutaneous coronary intervention (pci) were enrolled and divided into LVMI with and without RVMI groups. Between-group differences and in-hospital outcomes were compared. compared to patients without RVMi, patients with RVMi were more likely to be male, have higher body mass index, serum levels of C-reactive protein (8.9 ± 2.4 vs 6.2 ± 2.1 mg/dL), B-type natriuretic peptide (1295 ± 340 vs 872 ± 166 pg/mL) and cardiac troponin-I (8.6 ± 2.9 vs 5.2 ± 2.1 ng/ mL), and have diabetes (36.3% vs 3.4%) and dyslipidemia (53.4% vs 48.1%). Patients with RVMI had lower left and right ventricular ejection fraction (50.5 ± 5.6% vs 53.4 ± 3.8% and 33.6 ± 2.9% vs 45.7 ± 2.0%), but had higher mean pulmonary artery pressure (30.6 ± 3.3 vs 23.8 ± 3.1 mm Hg). compared to patients without RVMi, patients with RVMi had higher odds of in-hospital allcause mortality (4.1% vs 1.0%) and new onset acute heart failure (3.4% vs 1.0%). After adjusted for confounding factors, LVMi with RVMi remained independently associated with composite outcomes, with odds ratio 1.66 (95% confidence interval 1.39-2.04). Compared to isolated LVMI patients, those with concomitant RVMi have higher odds of in-hospital complications, particularly all-cause mortality and new onset acute heart failure.

Correlation between Right Ventricular Function with Revascularization Time and 30-day Mortality in ST-Elevation Myocardial Infarction Patients Underwent Right Coronary Artery Intervention

“…Morbidity and mortality are well known to be associated with right ventricular (RV) involvement after an acute myocardial infarction (MI). 17 In 50% to 80% postmortem and animal studies, RV involvement in acute MI has been reported but is frequently underestimated in the clinical setting owing to the diagnostic limitations of the electrocardiogram (ECG) and echocardiography. However in this study, we found that right ventricular function measured by TAPSE was not associated with TIMI score as predicted score for 30 days mortality of STEMI patients.…”

Right Atrial Volume Index as a Predictor of Persistent Right Ventricular Dysfunction in Patients with Acute Inferior Myocardial Infarction and Proximal Right Coronary Artery Occlusion Treated with Primary Percutaneous Coronary Intervention

“…They reported that patients with concomitant RVMI have higher of inhospital complications, particularly all-cause mortality and new onset acute HF. [17] .…”

Right ventricular failure in left heart disease: from pathophysiology to clinical manifestations and prognosis

“…The most common causes of acute RHF are pulmonary embolism and acute myocardial infarction, mainly, but not exclusively, secondary to occlusion of the right coronary artery [ 12 ] (Table 1 ). Less frequently, acute RHF develops after cardiac surgery or LV assist device (LVAD) implantation [ 13 ].…”