Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction with ST Segment-Elevation: Effect on the Severity of Ischemic Mitral Regurgitation

Document Type : Original Article

Authors

1 Department of Cardiology, Damietta Faculty of Medicine, Al-Azhar University, Egypt

2 Department of Cardiology, Faculty of Medicine, Al-Azhar University, Egypt

10.21608/ijma.2021.50324.1210

Abstract

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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