Abstract
To compare in-hospital outcomes between left ventricular myocardial infarction (LVMI) patients with and without right ventricular myocardial infarction (RVMI). Patients with acute ST-segment elevation MI (STEMI) undergoing primary percutaneous coronary intervention (PCI) were enrolled and divided into LVMI with and without RVMI groups. Between-group differences and in-hospital outcomes were compared. Compared to patients without RVMI, patients with RVMI were more likely to be male, have higher body mass index, serum levels of C-reactive protein (8.9 ± 2.4 vs 6.2 ± 2.1 mg/dL), B-type natriuretic peptide (1295 ± 340 vs 872 ± 166 pg/mL) and cardiac troponin-I (8.6 ± 2.9 vs 5.2 ± 2.1 ng/mL), and have diabetes (36.3% vs 3.4%) and dyslipidemia (53.4% vs 48.1%). Patients with RVMI had lower left and right ventricular ejection fraction (50.5 ± 5.6% vs 53.4 ± 3.8% and 33.6 ± 2.9% vs 45.7 ± 2.0%), but had higher mean pulmonary artery pressure (30.6 ± 3.3 vs 23.8 ± 3.1 mm Hg). Compared to patients without RVMI, patients with RVMI had higher odds of in-hospital all-cause mortality (4.1% vs 1.0%) and new onset acute heart failure (3.4% vs 1.0%). After adjusted for confounding factors, LVMI with RVMI remained independently associated with composite outcomes, with odds ratio 1.66 (95% confidence interval 1.39–2.04). Compared to isolated LVMI patients, those with concomitant RVMI have higher odds of in-hospital complications, particularly all-cause mortality and new onset acute heart failure.
Highlights
To compare in-hospital outcomes between left ventricular myocardial infarction (LVMI) patients with and without right ventricular myocardial infarction (RVMI)
Patients hospitalized in our department between January of 2017 to December of 2018 were screened and patients with acute ST-segment elevation MI (STEMI) undergoing primary percutaneous coronary intervention (PCI) were enrolled and divided into LVMI with and without RVMI groups
Demographics including age, gender and body mass index (BMI) calculated by weight in kilogram divided by height in squared meters; Acute myocardial infarction (AMI) risk factors including smoking status, hypertension, dyslipidemia and diabetes mellitus; laboratory parameters including fasting blood glucose, total cholesterol, C-reactive protein (CRP), B-type natriuretic peptide (BNP), cardiac troponin-I (CTn-I) and creatinine were collected from electronic medical record
Summary
To compare in-hospital outcomes between left ventricular myocardial infarction (LVMI) patients with and without right ventricular myocardial infarction (RVMI). Between-group differences and in-hospital outcomes were compared. Compared to patients without RVMI, patients with RVMI had higher odds of in-hospital allcause mortality (4.1% vs 1.0%) and new onset acute heart failure (3.4% vs 1.0%). Compared to isolated LVMI patients, those with concomitant RVMI have higher odds of in-hospital complications, all-cause mortality and new onset acute heart failure. Limited evidence indicates that compared to LVMI patients without RVMI, their counterparts with RVMI has poorer outcomes. We conducted a retrospective study to compare in-hospital outcomes between LVMI patients with and without RVMI. We tentatively explored the underlying mechanisms associated with the poorer outcomes in LVMI patients with RVMI. We considered that data from our current study would provide novel insights into the impact of RVMI on outcomes
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