H. Bueno et al., COMBINED EFFECT OF AGE AND RIGHT-VENTRICULAR INVOLVEMENT ON ACUTE INFERIOR MYOCARDIAL-INFARCTION PROGNOSIS, Circulation, 98(17), 1998, pp. 1714-1720
Citations number
36
Categorie Soggetti
Peripheal Vascular Diseas",Hematology,"Cardiac & Cardiovascular System
Background-In patients with acute inferior myocardial infarction (AIMI
), right ventricular involvement (RVI) is one of the strongest predict
ors of in-hospital death. We hypothesized that the impact of RVI on AI
MI prognosis depends on the patient's age. Methods and Results-The in-
hospital clinical outcome of 798 consecutive patients admitted to the
coronary care unit within 48 hours of symptom onset with AIMI was anal
yzed according to patient age and to the presence of RVI diagnosed by
ECG and/or echocardiographic criteria. The total incidence of RVI was
37%, and it increased as age advanced. Patients with RVI had a signifi
cantly higher incidence of major complications (45% versus 19%, P<0.00
01) and a higher in-hospital mortality rate (22% versus 6%, P<0.0001).
The prognostic effect of RVI was independent of sex, smoking, diabete
s, shock on admission, left ventricular ejection fraction, and reperfu
sion therapy, all age-dependent predictors. A multivariate analysis sh
owed a significant (P=0.03) interaction between age and RVI on AIMI mo
rtality. RVI increased mortality risk only in the oldest patients. Con
clusions-In patients with AIMI, RVI substantially increases mortality
risk in elderly patients, whereas it has a nonsignificant effect in yo
ung subjects.