Abstract 12659: Pericardial Effusion in Acute Myocardial Infarction : New Insights From the French Regional Rico Survey
Aim: Early post-acute myocardial infarction pericardial effusion are the major pericardial complications . We aimed to analyse the frequency, treatments, characteristics and prognostic significance of pericardial effusion (PE) following acute myocardial infarction.
Methods: From the French regional RICO survey database, all the patients hospitalized between January 1st 2001 and december 31st 2009 for an acute myocardial infarction from the 6 private or public center of Côte d'Or with echocardiographic examination were included in the study. The diagnosis of PE was made by echocardiography, which was performed within 48H after hospital admission. Data from patients with and without PE were compared at baseline and at follow-up.
Results. During the inclusion period, 8680 patients were included in the study, of whom 135 (1.5%) were diagnosed with PE. Patients with and without PE had similar risk factors, including age and sex ratio and time delays to admission. Interestingly, dyslipidemia and history of MI was less frequent in PE group (respectively 31 vs 45%, p=0.002 and 4 vs 13%, p=0.004). Plasma CRP levels on admission were markedly higher in PE patients (21 vs 6 mg/l, p<0.001). Prior chronic treatments were less frequent in PE group, in particular for aspirin (11 vs 19%, p=0.027), ACE inhibitor (10 vs 18%, p=0.014) and statin (15 vs 23%, p=0.054). Acute treatments were similar, except for BetaBlocker that were more used in patients without PE. Patients with PE were more likely to suffer from STEMI (76 vs 48%, p<0.01), and altered LVEF. Hospital complications such as death, or heart failure (12 vs 7%, p=0.016, 47 vs 28%, p=0.001), and mechanical complications including atrial fibrillation, wall rupture, apical thrombus and mitral regurgitation (respectively, 20 vs 9%, p<0.001, 7 vs 0.5%, p<0.01, 8 vs 0.7%, p<0.01, and 8 vs 3%, p=0.03) were more frequent in PE group.
Conclusions. Our large study showed that, although PE is uncommon in the contemporary era of acute MI, this complication is still associated with worse short term prognosis, characterized by high rate of mechanical complications. Our works also suggest a preventive effect of some CV drugs against the development of PE following acute MI.
- © 2011 by American Heart Association, Inc.