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Long-term prognostic value of mitral regurgitation in acute coronary syndromes
University of Borås, School of Health Science. [external].
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2010 (English)In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 96, no 22, p. 1803-1808Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To determine the additional prognostic value of mitral regurgitation (MR) over B-type natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and clinical characteristics in patients with acute coronary syndromes (ACS). DESIGN: Long-term follow-up in a prospective ACS cohort with Doppler-assessed MR, echocardiographically-determined LVEF and plasma BNP levels by ELISA. SETTING: Single-centre university hospital. PATIENTS: 725 patients with ACS. MAIN OUTCOME MEASURES: Death and readmission for congestive heart failure. RESULTS: During a median follow-up of 98 months, 235 patients (32%) died. Significant MR (grade >1 of 4) was found in 90 patients (12%). In a multivariate model including MR grade >1, LVEF <0.40 and BNP >373 pg/ml (75th percentile), MR was significantly associated with long-term mortality (HR 2.28, 95% CI 1.67 to 3.12; p<0.0001). When also adjusting for conventional risk factors, MR remained significantly associated with mortality (HR 1.53, 95% CI 1.06 to 2.19; p=0.02), as well as with congestive heart failure (HR 2.08, 95% CI 1.29 to 3.35; p=0.003). CONCLUSIONS: MR is common in patients with ACS, provides independent risk information and should be taken into account in the evaluation of the long-term prognosis.

Place, publisher, year, edition, pages
BMJ Group , 2010. Vol. 96, no 22, p. 1803-1808
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Medical and Health Sciences
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URN: urn:nbn:se:hb:diva-8114DOI: 10.1136/hrt.2010.203059Local ID: 2320/9837OAI: oai:DiVA.org:hb-8114DiVA, id: diva2:888997
Available from: 2015-12-22 Created: 2015-12-22 Last updated: 2017-10-20Bibliographically approved

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Publisher's full texthttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2976074/pdf/heartjnl203059.pdf

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Herlitz, Johan

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