Predictors of In-Hospital Mortality in Patients with Acute Inferior Infarction of the Left Ventricle Accompanied by Right Ventricular Infarction when Treated with Percutaneous Coronary Intervention

Abstract

Introduction: Right ventricular infarction (RVI) significantly increases the risk of in-hospital mortality in patients with acute inferior infarction of the left ventricle (AIILV). The present study evaluated pre-procedural and intra-procedural predictors of in-hospital mortality in patients with AIILV, accompanied by right RVI, when treated with primary percutaneous coronary intervention (PCI). Methods: 237 patients with acute inferior infarction of the left ventricle accompanied with RVI and treated with PCI were admitted to the Coronary Care Unit at Clinical Centre of Serbia, from 2007 until 2009. In-hospital mortality was 4.2%. Results: Using a multivariate logistic regression model, two independent risk-factors for in-hospital mortality were identified: cardiogenic shock caused by right ventricular insufficiency (54.5% vs. 4.5% without cardiogenic shock, p=0.002) and post-procedural TIMI flow 1 (p = 0.019) and previous PCI (p=0.021). Conclusions and clinical implications: Cardiogenic shock and post-procedural TIMI flow <3 in the infarcted artery are independent predictors of in-hospital mortality. In patients without cardiogenic shock, the risk for in-hospital mortality correlates with the degree of left ventricular insufficiency and previous PCI.