Impact of Right Ventricular Failure on the Outcomes of Acute Inferior Wall Myocardial Infarction
Author Type(s)
Faculty, Resident/Fellow
Document Type
Abstract
Publication Date
2022
DOI
10.1016/j.jacc.2022.08.050
Journal Title
Journal of the American College of Cardiology
Department
Medicine
Abstract
Background: Prior studies have shown Right Ventricular (RV) infarction to be an independent predictor of major complications and in-hospital mortality after acute myocardial infarction (MI). However, there is no contemporary large-scale studies to demonstrate the outcomes and of concomitant RV failure inferior MI. Methods: We used NIS 2018-19 to identify patients with acute inferior MI with or without RV failure. Primary outcome was inhospital mortality. Propensity matching based upon 30 variables was performed. Survey specific techniques were used to perform all pre and post matched analyses. Results: Amongst 182,485 acute inferior MI patients, 1,005 patients (0.5%) had RV failure. Patients with RV failure were older (68.4 vs 63.9 years), had longer length of stay (6.0 vs 4.7 days), and had a significantly higher mean cost of care (64,916 vs 26,396 USD). RV failure cohort had higher prevalence of chronic kidney disease, liver disease, atrial fibrillation, chronic obstructive pulmonary disease, and prior history of coronary bypass, P < 0.05 for all. After propensity matching, there was higher in-hospital mortality in RV failure group (34.2% vs 22%, P < 0.001). There was also a significantly higher number of patients who had a cardiogenic shock, acute kidney injury, vasopressor use, and mechanical support device use in RV failure group, P < 0.05 for all. [Formula presented] [Formula presented] Conclusion: Right ventricular failure adds significant mortality and morbidity burden in patients presenting with acute inferior MI. Further studies should explore whether early mechanical support would improve outcomes in these high-risk patients. Categories: CORONARY: Acute Coronary Syndromes
Recommended Citation
Malik, A., Bandyopadhyay, D., Goel, A., Gupta, R., Shetty, S., Hajra, A., Aronow, W., Vazquez, C., Haidry, S. A., & Ahmad, H. (2022). Impact of Right Ventricular Failure on the Outcomes of Acute Inferior Wall Myocardial Infarction. Journal of the American College of Cardiology, 80 (12), B16. https://doi.org/10.1016/j.jacc.2022.08.050
