Journal Article

The impact of pre-existing aortic stenosis and mitral regurgitation on patients with acute myocardial infarction

Hromadka, Milan, Šramko, Marek, Mrozek, Jan, Jarkovsky, Jiri, Motovska, Zuzana, Muzafarova, Tamilla, Hlinomaz, Ota, Ionita, Oana, Petr, Robert, Kala, Petr, Hutyra, Martin, Tomasov, Pavol, Santi, Pilar Lopez, Chua, Aileen Paula, Vichova, Teodora

2025

Overview

The prevalence of left-sided valvular heart disease (VHD) increases with age, but data on the impact of pre-existing VHD in patients with acute myocardial infarction (AMI) are limited. We aimed to define the clinical characteristics and outcomes of AMI patients with pre-existing left VHD. The analysis is based on data from three merged national registries. The dataset included 47,436 patients admitted with AMI over a 5year period at all Cath Labs nationwide. Pre-existing VHD was diagnosed in 1,445 patients (3.0%), moderate-to-severe mitral regurgitation (MR) in 510 patients (35.3%), and moderate-to-severe aortic stenosis (AS) in 869 patients (60.1%). Patients with VHD had worse baseline characteristics, pre-existing coronary artery disease, more complicated in-hospital course with higher Killip class, lower left ventricular ejection fraction, and more comorbidities. Angiographically more frequent left main stenosis, TIMI flow 3 before PCI, less frequent stent implantation. Patients with pre-existing VHD had significantly higher 7-day (10.1% vs. 4.5%, p  < 0.001), 30-day (16.0% vs. 7.0%, p  < 0.001) and 1-year mortality (28.7 vs. 12.7%, p  < 0.001) compared to patients without. Conclusions. Patients with pre-existing VHD and AMI are characterized by complicated in-hospital course with higher Killip class, lower ejection fraction, angiographically less severe stenosis, TIMI flow 3 prior to PCI, and less frequent stent implantation. This is a high-risk group with higher short – and long-term mortality and earlier intervention should be considered.

• Publisher: Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
• Subject: 692/4019/592 / 692/499 / Aged / Aged, 80 and over / Aortic stenosis / Aortic Valve Stenosis - complications / Aortic Valve Stenosis - epidemiology / Cardiovascular disease / Cardiovascular diseases / Comorbidity / Coronary artery disease / Ejection fraction / Female / Heart attacks / Heart diseases / Humanities and Social Sciences / Humans / Implants / Male / Middle Aged / Mitral Valve Insufficiency - complications / Mitral Valve Insufficiency - epidemiology / Mortality / multidisciplinary / Myocardial infarction / Myocardial Infarction - complications / Myocardial Infarction - mortality / Patients / Registries / Regurgitation / Risk Factors / Risk groups / Science / Science (multidisciplinary)