0190: Predictive factors of intrahospital mortality in patients with right ventricular myocardial infarction

Abstract

Right ventricular (RV) infarction is a serious and life threatening condition which mainly complicates an inferior wall myocardial infarction (MI). In the literature, data for predictive factors of mortality in this setting remains scarce. Aim to study predictive factors of intrahospital mortality in patients with RV infarction. Data was collected from a monocenter registry including all patients with AMI admitted in our department between January 1995 and March 2013. 1483 patients were enrolled in our registry. RV infarction was diagnosed in 160 (10.7%) patients, always complicating an inferior wall MI. 37 (23.1%) patients presented with right sided heart failure while the remaining patients presented with isolated features of RV involvement on the ECG with ST elevation in the right leads. Intrahospital death occurred in 20 patients (12.5%) and was significantly higher in patients with RV heart failure (p=0.02). Among all deaths included in our registry, RV infarction was responsible for 14.5%. The reperfusion strategy was Thrombolysis in 48 patients (30%), angioplasty in 62 patients (38.8%), a combined approach in 10 cases (6.3%) and conservative treatment in 40 cases (25%). There was no difference in mortality among all strategies (p: 0.556). In patients who had angioplasty, post procedural TIMI flow 0 or 1 was associated with a higher mortality (p<0.001). In a multivariate analysis, factors found to predict intra-hospital mortality were: renal impairment defined as creatinin levels >130umol/l (OR: 8.22; 95% CI [1.33-50.9]; p: 0.023), triple vessel disease (OR: 7.09; 95% CI [1.738-28.93]; p: 0.006) and left ventricular failure with KILLIP >1 (p: 0.004). Our data support the fact that several factors may predict intra-hospital mortality after RV myocardial infarction among which renal impairment, the extent of coronary artery disease and left ventricular heart failure are most the powerful predictors.