Prevalence and Severity of Mitral Regurgitation Following Acute Myocardial Infarction: Impact of Delayed Revascularization and Comorbidities

Abstract

Objectives: To evaluate the frequency and severity of mitral regurgitation (MR) in patients following acute myocardial infarction (AMI) and to examine the association between MR severity, delayed revascularization, and comorbid conditions. Methodology: We conducted a retrospective review of 170 patients diagnosed with AMI who underwent echocardiographic examination during their index admission. The severity of MR was categorized as mild, moderate, or severe based on echocardiographic findings. Demographic, clinical, and echocardiographic data were analyzed using SPSS software to explore associations between MR severity and factors such as hypertension, previous myocardial infarction (MI), heart failure (HF), and the timing of revascularization. Results: Among the 170 patients, 75% exhibited mild MR, 20% had moderate MR, and 5% had severe MR. Chi-square analysis revealed significant associations between MR severity and hypertension, prior MI, and heart failure (p < 0.05). Independent t-tests showed that older age and reduced left ventricular ejection fraction (LVEF) were significantly correlated with more severe MR (p < 0.05). Delayed revascularization was identified as a significant predictor of severe MR, with patients undergoing revascularization more than 3 days post-AMI exhibiting a higher incidence of moderate-to-severe MR. The mode of revascularization (percutaneous coronary intervention (PCI), thrombolytics, or no revascularization) was also significantly associated with MR severity. Conclusion: MR is a frequent complication following AMI, with its severity closely linked to delayed revascularization and the presence of comorbidities. Early intervention, timely revascularization, and effective management of risk factors are crucial in preventing the progression to severe MR and improving patient outcomes.

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Pakistan Heart Journal; Vol. 58 No. 2 (2025), pp. 118-124

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