Key result
Primary percutaneous coronary intervention significantly improved ejection fraction (P<0.001) and reduced ischemic mitral regurgitation severity parameters after six months in patients with STEMI.
Why the study?
The study aimed to detect the impact of primary percutaneous coronary intervention on the development and severity of mitral valve regurgitation in patients presenting with acute STEMI.
Does primary percutaneous coronary intervention improve the severity of ischemic mitral regurgitation in patients with acute STEMI compared to streptokinase and pharmaco-invasive PCI?
Cross-Sectional (n=105)
No
Does primary percutaneous coronary intervention improve the severity of ischemic mitral regurgitation in patients with acute STEMI compared to streptokinase and pharmaco-invasive PCI?
p-value: p=<0.001
Primary PCI for STEMI improves echocardiographic parameters of ischemic mitral regurgitation at 6 months compared to thrombolysis-based strategies.
PPCI may reduce IMR incidence and severity in STEMI; leaves open need for prospective trials before practice change.
Background: Myocardial infarction is a daily challenging emergency. Proper diagnosis and intervention in a timely manner is crucial. The aim of the work: We aimed to detect the impact of primary percutaneous coronary intervention [PPCI] on the development and severity of mitral valve regurgitation in patients presenting with acute myocardial infarction with ST-segment elevation [STEMI]. Patients and Methods: This was a cross-sectional comparative study that was conducted from January 2018 to November 2019 at the Department of Cardiology, Al-Azhar University Hospital, Damietta, Egypt. Patients were divided into four groups; Group I: STEMI patients with PPCI and single-vessel disease; Group II: STEMI patients with PPCI of culprit vessel and staged PCI with in-hospital admission; Group III: STEMI patients with streptokinase and pharmaco-invasive PCI of the single vessel; Group IV: STEMI patients with streptokinase and multi-vessel PCI at the same session. Results: One-hundred and five patients were included in this study. Patients in group I showed a significant improvement after six months of follow-up in terms of ejection fraction [p <0.001]. Regarding the coaptation height, it showed a significant elevation in group I [p <0.001], and a significant reduction in group II [p <0.001] and III [p=0.013]. Similarly, PISA reduced significantly after six months in group I [p <0.001], II [p=0.002], and IV [p=0.007]. EPSS was reduced significantly in group I [p=0.0004]. Likewise, the distance of intrapapillary showed a significant reduction in group I [p <0.001]. Regarding the regurgitant area, it was significantly [p <0.05] reduced in all groups. Conclusion: Our results showed that PPCI could decrease the incidence and the severity of IMR and improve IMR parameters, especially in patients with acute STEMI. Further well-designed longitudinal studies with a larger sample size are required to evaluate these findings.
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Hammad et al. (2021) conducted a cross-sectional in Acute myocardial infarction with ST-segment elevation (STEMI) (n=105). Primary percutaneous coronary intervention (PPCI) vs. Streptokinase with pharmaco-invasive or multi-vessel PCI was evaluated on Severity of ischemic mitral regurgitation (ejection fraction, coaptation height, PISA, EPSS, regurgitant area) (p=<0.001). Primary percutaneous coronary intervention significantly improved ejection fraction (P<0.001) and reduced ischemic mitral regurgitation severity parameters after six months in patients with STEMI.
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