The Third People Hospital of Huizhou, The Affiliated Hospital of Guangzhou Medical University, Huizhou, Guangdong, China.
Sci Rep. 2020 Feb 3;10(1):1736. doi: 10.1038/s41598-020-58713-0.
To compare in-hospital outcomes between left ventricular myocardial infarction (LVMI) patients with and without right ventricular myocardial infarction (RVMI). Patients with acute ST-segment elevation MI (STEMI) undergoing primary percutaneous coronary intervention (PCI) were enrolled and divided into LVMI with and without RVMI groups. Between-group differences and in-hospital outcomes were compared. Compared to patients without RVMI, patients with RVMI were more likely to be male, have higher body mass index, serum levels of C-reactive protein (8.9 ± 2.4 vs 6.2 ± 2.1 mg/dL), B-type natriuretic peptide (1295 ± 340 vs 872 ± 166 pg/mL) and cardiac troponin-I (8.6 ± 2.9 vs 5.2 ± 2.1 ng/mL), and have diabetes (36.3% vs 3.4%) and dyslipidemia (53.4% vs 48.1%). Patients with RVMI had lower left and right ventricular ejection fraction (50.5 ± 5.6% vs 53.4 ± 3.8% and 33.6 ± 2.9% vs 45.7 ± 2.0%), but had higher mean pulmonary artery pressure (30.6 ± 3.3 vs 23.8 ± 3.1 mm Hg). Compared to patients without RVMI, patients with RVMI had higher odds of in-hospital all-cause mortality (4.1% vs 1.0%) and new onset acute heart failure (3.4% vs 1.0%). After adjusted for confounding factors, LVMI with RVMI remained independently associated with composite outcomes, with odds ratio 1.66 (95% confidence interval 1.39-2.04). Compared to isolated LVMI patients, those with concomitant RVMI have higher odds of in-hospital complications, particularly all-cause mortality and new onset acute heart failure.
比较左心室心肌梗死（LVMI）合并和不合并右心室心肌梗死（RVMI）患者的住院结局。入选接受直接经皮冠状动脉介入治疗（PCI）的急性 ST 段抬高型心肌梗死（STEMI）患者，并分为合并 RVMI 和不合并 RVMI 两组。比较组间差异和住院结局。与无 RVMI 患者相比，RVMI 患者更可能为男性，BMI 更高，血清 C 反应蛋白（8.9±2.4 比 6.2±2.1mg/dL）、B 型利钠肽（1295±340 比 872±166pg/mL）和肌钙蛋白 I（8.6±2.9 比 5.2±2.1ng/mL）水平更高，且合并糖尿病（36.3%比 3.4%）和血脂异常（53.4%比 48.1%）。RVMI 患者左、右心室射血分数更低（50.5±5.6%比 53.4±3.8%和 33.6±2.9%比 45.7±2.0%），但平均肺动脉压更高（30.6±3.3 比 23.8±3.1mmHg）。与无 RVMI 患者相比，RVMI 患者住院全因死亡率（4.1%比 1.0%）和新发急性心力衰竭（3.4%比 1.0%）的可能性更高。调整混杂因素后，LVMI 合并 RVMI 与复合结局仍独立相关，比值比为 1.66（95%置信区间 1.39-2.04）。与孤立性 LVMI 患者相比，同时合并 RVMI 的患者住院并发症的可能性更高，特别是全因死亡率和新发急性心力衰竭。
