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RESEARCH PRODUCT
Mitral Regurgitation and Prognosis After Non-ST-Segment Elevation Myocardial Infarction in Very Old Patients.
Violeta González-salvadoAlberto VeraIsaac LlaóRamón López-palopJuan SanchisAlessandro SionisHéctor García-pardoJorge SalamancaPablo Díez-villanuevaEmad Abu-assiMaría T. VidánManuel Martínez-sellésFernando AlfonsoOriol AlegreAlbert Ariza-soléFrancesc FormigaHéctor BuenoFrancisco Marínsubject
Malemedicine.medical_specialtyAcute coronary syndromeEnfermedad cardiovascularAnciano030204 cardiovascular system & hematology03 medical and health sciences0302 clinical medicineRisk FactorsInternal medicinemedicineST segmentHumans030212 general & internal medicineMyocardial infarctionHospital MortalityProspective StudiesRegistriesNon-ST Elevated Myocardial InfarctionKillip classProportional Hazards ModelsAged 80 and overEjection fractionbusiness.industryHazard ratioMitral Valve InsufficiencyLength of Staymedicine.diseasePrognosisConfidence intervalGeriatríaBlood pressureEchocardiographyCardiologyVálvulas cardíacasFemaleGeriatrics and GerontologyInfarto de miocardiobusinessdescription
Background/Objetctives: Mitral regurgitation (MR)after an acute coronary syndrome is associated with a poor prognosis. However,the prognostic impact of MR in elderly patients with non-ST-segment elevation myocardialinfarction (NSTEMI) has not been well addressed. Design: Prospective registry. Setting And Participants: The multicenter LONGEVO-SCA prospective registry included 532 unselected NSTEMI patients aged ≥80 years. Measurements: MR was quantified using echocardiography during admission in 497 patients. They were classified in two groups: significant (moderate or severe) or not significant MR (absent or mild). We evaluated the impact of MR status on mortality or readmission at 6 months. Results: Mean age was 84.3±4.1 years, and 308 (61.9%) were males. A total of 108 patients (21.7%) had significant MR. Compared with those without significant MR, they were older and showed worse baseline clinical status, with higher frailty, disability, and risk of malnutrition. They also had lower systolic blood pressure, higher heart rate, worse Killip class, lower left ventricular ejection fraction, and higher pulmonary pressure on admission, as well as more often new onset atrial fibrillation (all p values = 0.001). Patients with significant MR also had higher in-hospital mortality (4.6% vs. 1.3%, p = 0.04), longer hospital stay (median 8 [5-12] vs. 6 [4-10] days, p = 0.002), and higher mortality/readmission at 6 months (hazard ratio 1.54, 95% confidence interval 1.09-2.18, p = 0.015). However, after adjusting for potential confounders, this last association was not significant. Conclusions: Significant MR is seen in one fifth of octogenarians with NSTEMI. Patients with significant MR have a poor prognosis, mainly determined by their baseline clinical characteristics. Sin financiación 4.180 JCR (2019) Q1, 2/36 Gerontology, 12/51 Geriatrics & Gerontology 1.926 SJR (2019) Q1, 7/109 Geriatrics and Gerontology No data IDR 2019 UEM
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2019-05-02 | Journal of the American Geriatrics Society |