What question did this study set out to answer?

To determine whether mitral regurgitation provides independent long-term prognostic value beyond B-type natriuretic peptide, left ventricular ejection fraction, and standard clinical risk factors in acute coronary syndrome patients.

September 28, 2010HeartOpen Access

Long-term prognostic value of mitral regurgitation in acute coronary syndromes

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Why the study?

Does significant mitral regurgitation predict long-term mortality and heart failure readmission in patients with acute coronary syndromes?

Key Points

To determine whether mitral regurgitation provides independent long-term prognostic value beyond B-type natriuretic peptide, left ventricular ejection fraction, and standard clinical risk factors in acute coronary syndrome patients.
Prospective single-center cohort study evaluating 725 patients admitted with acute coronary syndromes.
Assessed mitral regurgitation severity and left ventricular ejection fraction via echocardiography, measured plasma B-type natriuretic peptide using ELISA, and followed patients for a median of 98 months for mortality and heart failure readmission.
Significant mitral regurgitation (grade >1 of 4) was present in 90 patients (12%), and 235 patients (32%) died during the 98-month follow-up.
After multivariate adjustment for conventional risk factors, left ventricular ejection fraction <0.40, and B-type natriuretic peptide >373 pg/ml, significant mitral regurgitation remained independently associated with all-cause mortality (HR 1.53, 95% CI 1.06 to 2.19; p=0.02) and congestive heart failure readmission (HR 2.08, 95% CI 1.29 to 3.35; p=0.003).

Structured PICO

Does significant mitral regurgitation predict long-term mortality and heart failure readmission in patients with acute coronary syndromes?

Population

725 patients with acute coronary syndromes (ACS)

Intervention

Presence of significant mitral regurgitation (grade >1 of 4) assessed by Doppler echocardiography

Comparator

Absence of significant mitral regurgitation (grade ≤1)

Outcome

Death and readmission for congestive heart failurehard clinical

Significant mitral regurgitation is common in ACS patients and provides independent prognostic information for long-term mortality and heart failure readmission.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Significant MR may refine long-term risk stratification in ACS; leaves open whether MR modification improves outcomes.

Cite This Study

Hartford et al. (2010) studied this question.

synapsesocial.com/papers/6a8d10b3851ec846c20e5642 https://doi.org/10.1136/hrt.2010.203059

Topics

HFrEF treatment Heart failure Mitral valve intervention

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Long-term prognostic value of mitral regurgitation in acute coronary syndromes

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Long-term prognostic value of mitral regurgitation in acute coronary syndromes

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider