TY - JOUR
T1 - The impact of moderate aortic stenosis in acute myocardial infarction
T2 - A multicenter retrospective study
AU - Abraham, Bishoy
AU - Farina, Juan M.
AU - Fath, Ayman
AU - Abdou, Merna
AU - Elbanna, Mostafa
AU - Suppah, Mustafa
AU - Sleem, Mohamed
AU - Eldaly, Abdullah
AU - Aly, Mohamed
AU - Megaly, Michael
AU - Agasthi, Pradyumna
AU - Chao, Chieh Ju
AU - Fortuin, David
AU - Alsidawi, Said
AU - Ayoub, Chadi
AU - Alkhouli, Mohamad
AU - El Sabbagh, Abdallah
AU - Holmes, David
AU - Brilakis, Emmanouil S.
AU - Arsanjani, Reza
N1 - Publisher Copyright:
© 2023 Wiley Periodicals LLC.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Background: Aortic stenosis (AS) is associated with myocardial ischemia through different mechanisms and may impair coronary arterial flow. However, data on the impact of moderate AS in patients with acute myocardial infarction (MI) is limited. Aims: This study aimed to investigate the impact of moderate AS in patients presenting with acute myocardial infarction (MI). Methods: We conducted a retrospective analysis of all patients who presented with acute MI to all Mayo Clinic hospitals, using the Enterprise Mayo PCI Database from 2005 to 2016. Patients were stratified into two groups: moderate AS and mild/no AS. The primary outcome was all cause mortality. Results: The moderate AS group included 183 (13.3%) patients, and the mild/no AS group included 1190 (86.7%) patients. During hospitalization, there was no difference between both groups in mortality. Patients with moderate AS had higher in-hospital congestive heart failure (CHF) (8.2% vs. 4.4%, p = 0.025) compared with mild/no AS patients. At 1-year follow-up, patients with moderate AS had higher mortality (23.9% vs. 8.1%, p < 0.001) and higher CHF hospitalization (8.3% vs. 3.7%, p = 0.028). In multivariate analysis, moderate AS was associated with higher mortality at 1-year (odds ratio 2.4, 95% confidence interval [1.4–4.1], p = 0.002). In subgroup analyses, moderate AS increased all-cause mortality in STEMI and NSTEMI patients. Conclusion: The presence of moderate AS in acute MI patients was associated with worse clinical outcomes during hospitalization and at 1-year follow-up. These unfavorable outcomes highlight the need for a close follow-up of these patients and for timely therapeutic strategies to best manage these coexisting conditions.
AB - Background: Aortic stenosis (AS) is associated with myocardial ischemia through different mechanisms and may impair coronary arterial flow. However, data on the impact of moderate AS in patients with acute myocardial infarction (MI) is limited. Aims: This study aimed to investigate the impact of moderate AS in patients presenting with acute myocardial infarction (MI). Methods: We conducted a retrospective analysis of all patients who presented with acute MI to all Mayo Clinic hospitals, using the Enterprise Mayo PCI Database from 2005 to 2016. Patients were stratified into two groups: moderate AS and mild/no AS. The primary outcome was all cause mortality. Results: The moderate AS group included 183 (13.3%) patients, and the mild/no AS group included 1190 (86.7%) patients. During hospitalization, there was no difference between both groups in mortality. Patients with moderate AS had higher in-hospital congestive heart failure (CHF) (8.2% vs. 4.4%, p = 0.025) compared with mild/no AS patients. At 1-year follow-up, patients with moderate AS had higher mortality (23.9% vs. 8.1%, p < 0.001) and higher CHF hospitalization (8.3% vs. 3.7%, p = 0.028). In multivariate analysis, moderate AS was associated with higher mortality at 1-year (odds ratio 2.4, 95% confidence interval [1.4–4.1], p = 0.002). In subgroup analyses, moderate AS increased all-cause mortality in STEMI and NSTEMI patients. Conclusion: The presence of moderate AS in acute MI patients was associated with worse clinical outcomes during hospitalization and at 1-year follow-up. These unfavorable outcomes highlight the need for a close follow-up of these patients and for timely therapeutic strategies to best manage these coexisting conditions.
KW - moderate arotic stenosis
KW - myocardia infarction
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U2 - 10.1002/ccd.30676
DO - 10.1002/ccd.30676
M3 - Article
C2 - 37146200
AN - SCOPUS:85158170794
SN - 1522-1946
VL - 102
SP - 159
EP - 165
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 1
ER -