Short-term effect of percutaneous coronary intervention on ischemic mitral regurgitation

• Main Authors: Hazem El-Akabawy, Hamdy Abdul Azeem, EL-Shazly Abdul Khalek
• Format: Article
• Language: English
• Published: Wolters Kluwer 2018-08-01
• Series: Egyptian Journal of Critical Care Medicine
• Online Access: http://www.sciencedirect.com/science/article/pii/S209073031830001X

Background: The effect of revascularization by PCI for acute coronary syndrome (ACS) on the severity of ischemic mitral regurge (IMR) is still unclear. Objective: To evaluate the effect of successful total revascularization by PCI for ACS on the degree of IMR. Methods: A total of 240 patients presenting with ACS for the first time were studied by this an open-label, multicenter, prospective clinical trial between July 2015 to February 2017. All patients were subjected for clinical assessment, transthoracic echocardiographic assessment and coronary angiography. The patients divided into two groups: group A; those who had undergone successful total revascularization of a significant coronary artery disease using PCI, and group B; those who had optimal medical treatment with no total revascularization, failed PCI or for CABG. Group A patients subdivided into subgroup I, patients with improvement of the IMR; and subgroup II, patients with no improvement of IMR. Results: Only 65% of the patients showed IMR and 149 of them underwent successful complete revascularization by PCI; 68% of them showed IMR improvement and 32% showed no improvement. There was a significant improvement of the IMR degree after total revascularization by PCI. Moreover, this improvement was significant in subgroup I (p < 0.001). Percutaneous coronary intervention, EF and SWMI were significant predictors of IMR improvement following successful complete revascularization. Conclusion: Successful total revascularization by early PCI improve IMR degree. Keywords: Ischemic mitral regurge, Total revascularization, Acute coronary syndrome, Percutaneous coronary intervention, Myocardial infarction, Echocardiography