FREQUENCY OF ISCHEMIC MITRAL REGURGITATION AFTER ACUTE ST- ELEVATION MYOCARDIAL INFARCTION AT A TERTIARY CARE CARDIAC CENTER

Abstract

Objectives: Among the common complications of coronary artery disease (CAD) is the ischemic mitral regurgitation (IMR). Identifying IMR and assessing its severity is pertinent owing to its significance in post- myocardial infarction (MI) risk stratification. It is associated with a higher risk of heart failure and mortality. This study aimed to determine the frequency of IMR after the first acute ST-elevation MI (STEMI) in the Pakistani population.

Methodology: A cross-sectional observational study was conducted at NICVD, Karachi between January and July 2021. One hundred and ninety-five consecutive participants of first acute ST elevation MI who fulfilled the diagnostic criteria of IMR were included in the study. Demographic and clinical profile was recorded. All patients underwent echocardiography to grade the severity of IMR. Data was entered and analyzed using SPSS version 20.

Results: Of 195 patients, 141 (72.3%) were males. 77 (39.5%) were diabetic, 92 (47.2%) were hypertensive, 18 (9.2%) had dyslipidemia and 58 (29.7%) used tobacco. IMR was observed in 74 (37.9%) with mild in 50 (67.6%), moderate in 18 (24.3%), and severe in 6 (8.1%) patients. IMR was statistically significantly associated with duration of symptoms, type of MI, diabetes mellitus, hypertension, and tobacco use.

Conclusion: IMR was prevalent in more than one-third of patients presenting with acute ST elevation MI. Severity of IMR was moderate to severe in about one-third of the patients. IMR was found to be associated with duration of symptoms, type of MI, diabetes mellitus, hypertension, and tobacco use. Considering its prognostic role, assessment of IMR and its severity is necessary for appropriate management of patients.