Ischemic Mitral Valve Regurgitation in Non-ST Elevation Myocardial Infarction Prevalence & Long Term Follow Up

Background: Ischemic Mitral Valve Regurgitation (IMR) is one of the most common and serious complications of acute Myocardial Infarction. Acute ST Elevation Myocardial Infarction has been a significant predictor for developing IMR. Little is known about the prevalence and natural history of IMR in Non-ST Elevation Myocardial Infarction Patients.

Method: We conducted a retrospective cohort study. The study populations included patients who were hospitalized in the ICCU due to acute myocardial infarction from January 2014 to December 2015. The patients were divided into two groups: STEMI and Non-STEMI. Primary end point was developing of Ischemic Mitral Insufficiency.

Results: 225 patients were found to be eligible for the study. 71.7% were men with an average age of 61.7 years. Of these, 92 patients were hospitalized due to STEMI and 133 patients were hospitalized for non-STEMI. The group of patients hospitalized for STEMI was characterized by an older age (65.2 ± 14.2 and 58.2 ± 11.8, respectively, p <.004) with a high prevalence of Co-morbidities. IMR developed in 94.2% of the STEMI group and 95.6% in the non-STEMI group. In both groups 60% of the patients developed Minimal to Mild Mitral regurgitation and 30% developed at least of moderate severity. There was no statistically significant difference between the two groups in the incidence of IMR. In 40% of patients in the STEMI group there was a worsening of the regurgitation compared with 16.7% in the non-STEMI group during 1 year follow up.

Conclusion: Our study indicates a particularly high prevalence of IMR in non-STEMI patients which was not differ significant to STEMI group. Old age and extensive myocardial damage were independent variables for IMR developing. Regurgitation severity Grade in Non-STEMI group seems to improve in at least 16.7% of patients at 1 year follow-up.