COMPARISON BETWEEN 30 DAYS MORTALITY IN PATIENTS OF CARDIOGENIC SHOCK WITH MITRAL REGURGITATION AND WITHOUT MITRAL REGURGITATION AFTER ACUTE MYOCARDIAL INFARCTION

Abstract

Background: As we all know that Cardiogenic shock is very worst complication of Acute MI. Acute MR is an important mechanical complication of Acute Myocardial infarction. These both complications have their own significant impact on mortality. When these both complications occur together then the prognosis of the patient is very bad and survival of the patient becomes very difficult. Objectives: This study is to determine the Comparison between 30 days mortality in patients of cardiogenic shock with mitral regurgitation and without mitral regurgitation after acute myocardial infarction. Materials & methods: Mitral Regurgitation assessed in 106 patients who admitted with Acute MI complicated by cardiogenic shock. Color Doppler of MR graded from 0 to 2 with 0 = mild MR, 1=Moderate MR and 2= Severe MR. Differences between subgroups of MR were tested using chi square test for Categorical variables. ANOVA and t-test applied for normally distributed continuous variables. Logistic regression analysis was used to investigate important predictors of mortality. Results: Out of 106 patients with cardiogenic shock after myocardial infarction, 53 had mitral regurgitation (MR). The overall 30-day mortality was 30.2%, higher in MR patients (37.7%) than those without MR (22.6%) (p = 0.091). Stratified analysis showed significantly higher mortality in MR patients who were smokers (p = 0.029), underwent PCI (p = 0.048), did not receive streptokinase (p = 0.023), or presented early to the ER (p = 0.035). Mortality was 100% in MR patients with ventricular tachycardia (p = 0.001). Multivariable logistic regression identified diabetes (AOR = 0.055, p = 0.001), hypertension (AOR = 0.095, p = 0.002), and severe MR (AOR = 136.3, p = 0.023) as independent predictors of 30-day mortality. Conclusions: Presence of MR is associated with increased 30 days mortality in acute MI patients complicated by cardiogenic shock.