Abstract 6086: Right Ventricular Infarction with Inferior ST-Elevation Myocardial Infarction has Higher Hospital Mortality than Anterior Myocardial Infarction
Background: Patients (pts) with inferior ST-elevation myocardial infarction (STEMI) generally have better outcomes than those with anterior infarctions. However, the additional impact of right ventricular (RV) infarction, present in up to 50% of inferior STEMIs, remains unclear.
Methods: Clinical features and outcomes of 154,579 pts with anterior and inferior STEMI with and without RV myocardial infarction (MI) were analyzed using the National Registry of Myocardial Infarction (NRMI). All STEMI pts eligible for reperfusion therapy in NRMI 3, 4 and 5 admitted from April 1998 – December 2006 were analyzed. The following groups were compared
Inferior MI without RV MI
Inferior MI with RV MI without shock
Inferior MI with RV MI and shock
Anterior MI without shock, and
Anterior MI with shock.
Results: Table 1⇓ shows the clinical and treatment characteristics for patients in each group. Mortality in inferior MI with RV MI and shock was second only to anterior MI with shock (figure⇓). On multivariate analysis, inferior MI with RV MI and shock (OR 2.75, 1.71– 4.42) and without shock (OR 1.41, 1.18 –1.67), had significantly higher mortality than anterior MI without shock, and was overall a significant predictor of mortality.
Conclusions: Right Ventricular MI with an Inferior STEMI with or without shock is a significant predictor of mortality and exceeds that of anterior MI without shock.