In-hospital outcome of patients with mitral regurgitation after acute st-elevation myocardial infarction

Objectives: To determine the frequency and in-hospital outcome of patients presenting with Mitral Regurgitation (MR) in Acute ST-Elevation Myocardial Infarction (STEMI). Materials and methods: This descriptive study was conducted at the Department of Cardiology, Punjab Institute of Cardiology, Lahore from April to September 2010. After fulfilling the inclusion criteria 350 patients patienst presenting with STEMI were studied. Demographic data, name, age, gender, and address were recorded on a predesigned proforma. Patients were assessed on transthoracic echocardiography by a consultant for presence or absence of mitral regurgitation. Patients were kept in the ward for at least three days. They were examined by the ward consultant for pulmonary edema or death immediately after diagnosis of mitral regurgitation and then every eight hours for the following three days. Results: There were 160(45.7%) males and 190(54.3%) females with a mean age of 55.4±8.9 years. Among 350 patients 135(38.6%) had mitral regurgitation and 215(61.4%) had no MR during the hospital stay. In the MR group MR observed was mild in majority 92(68.1%) of cases while it was moderate in 29(21.5%) and severe in 14(10.4%) patients. Overall in-hospital mortality was 44(12.6%), 20(14.8%) in MR group and 24(11.2%) in No MR group. Heart failure/acute pulmonary edema occurred in 84(24%) patients, 63(46.7%) in MR group and 21(9.8%) in No MR group. Among the study patients 222(63.4%) had uneventful discharge more 170(79.1%) in No MR group as compared to 52(38.5%) in MR group. Conclusion: There is high frequency of MR after MI in our population and mostly sufferers of this complication are females and elderly patients. MR if present after MI is associated with poor outcome in terms of death and acute heart failure.