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(Circulation. 2006;114:II_609.)
© 2006 American Heart Association, Inc.

Chronic Ischemic Heart Disease: Old and New Risk Indicators

Abstract 2903: Prevalence of Mitral Regurgitation and Their Impact on Prognosis in Patients with Coronary Artery Disease Undergone First Percutaneous Coronary Intervention

Neiko Ozasa¹; Ryoji Taniguchi²; Mitsuru Abe³; Satoshi Shizuta³; Yoshisumi Haruna³; Natsuhiko Ehara⁴; Yutaka Furukawa Furukawa⁵; Akira Nakano⁶; Jong-Dae Lee⁶; Koichi Morioka⁶; Kuniyoshi Tanaka⁶; Masaaki Takahashi⁷; Teiji Oda⁸; Saeko Minematsu⁹; Yukiko Imai¹⁰; Satoshi Teramukai¹⁰; Masanori Fukushima¹⁰; Takeshi Morimoto¹¹; Toru Kita¹²; Takeshi Kimura¹², on behalf of the CREDO-Kyoto Investigators

¹ Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch of Medicine, Kyoto, Japan
² Div of Cardiology, Hyogo Prefectural Amagasaki Hosp, Hyogo, Japan
³ Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch of Medicine, Kyoto, Japan
⁴ Div of Cardiology, Kobe General Hosp, Hyogo, Japan
⁵ Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch of Medicine, Kyoto, Japan
⁶ Univ of Fukui, Fukui, Japan
⁷ Hamamatsu Rosai Hosp, Shizuoka, Japan
⁸ Hamamatsu Rosai Hosp, Kyoto, Japan
⁹ Rsch Institute for Production Development, Kyoto, Japan
¹⁰ Translational Rsch Cntr, Kyoto Univ Hosp, Kyoto, Japan
¹¹ Cntr for Med Education, Kyoto Univ Graduate Sch of Medicine, Kyoto, Japan
¹² Dept of Cardiovascular Medicine, Kyoto Univ Graduate Sch of Medicine, Kyoto, Japan

Introduction: The prevalence of mitral regurgitation (MR) and its relation to survival in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) has not been well scrutinized.

Methods: We retrospectively analyzed collected data of 6366 patients who underwent first PCI outside of the setting of acute myocardial infarction between January 2000 and December 2002 at 30 hospitals in Japan. Survival status was completed for 100% of the patients. The degree of MR was evaluated by doppler echocardiography at enrollment. Patients with unknown MR status were excluded from this analysis.

Results: Doppler echocardiography was performed in 4215 patients at baseline (66.2%). Median-follow up of patients in this cohort was 2.5 years. Of the study population, 1466 of 4215 subjects had MR of any grade (34.8%). Patients with MR had worse clinical status (Table. 1). Three-year survivals for patients with no, mild, and moderate to severe MR differed significantly (log-rank test p<0.001). Adjusting for, age, left ventricular (LV) ejection fraction, LV dimension, number of disease vessel, history of myocardial infarction, New York Heart Association (NYHA) class, presence of atrial fibrillation, peripheral or aortic disease, diabetes, anemia, renal failure, history of brain infarction, cancer, chronic obstructive pulmonary disease, treatment with statins, diuretics, serum total cholesterol, serum HDL-cholesterol, and body mass index, hazard ratio for all cause mortality of mild to severe MR compared to no MR was 1.48 (95% confidence interval 1.05–2.10, p=0.026). Adjusting for the same variables, hazard ratio of moderate to severe MR compared to no to mild MR was 1.25 (not significant).

Conclusions: MR seemed to be common in patients with coronary artery disease undergoing PCI. The presence of MR was significantly associated with worsened survival independently of baseline characteristics and the degree of LV ejection fraction.

Table. 1 Baseline Characteristics

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