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Prognostic Implication of Tricuspid Regurgitation in STEMI Patients
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  • Ben Sadeh,
  • Tamar Itach,
  • Ilan Merdler,
  • Yogev Peri,
  • Shir Frydman,
  • Samuel Morgan,
  • Aviram Hochstadt,
  • Yotam Pasternak,
  • Yan Topilsky,
  • Shmuel Banai,
  • Yacov Shacham
Ben Sadeh
Tel Aviv University Sackler Faculty of Medicine
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Tamar Itach
Tel Aviv Sourasky Medical Center
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Ilan Merdler
Tel Aviv University Sackler Faculty of Medicine
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Yogev Peri
Tel Aviv University Sackler Faculty of Medicine
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Shir Frydman
Tel Aviv University Sackler Faculty of Medicine
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Samuel Morgan
Tel Aviv University
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Aviram Hochstadt
Tel Aviv University Sackler Faculty of Medicine
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Yotam Pasternak
Tel Aviv University Sackler Faculty of Medicine
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Yan Topilsky
Tel Aviv Medical Center
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Shmuel Banai
Tel Aviv Medical Center
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Yacov Shacham
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Peer review status:UNDER REVIEW

15 May 2020Submitted to Echocardiography
16 May 2020Submission Checks Completed
16 May 2020Assigned to Editor
17 May 2020Reviewer(s) Assigned
07 Jun 2020Review(s) Completed, Editorial Evaluation Pending
07 Jun 2020Editorial Decision: Revise Major
29 Jun 20201st Revision Received
30 Jun 2020Submission Checks Completed
30 Jun 2020Assigned to Editor
30 Jun 2020Reviewer(s) Assigned

Abstract

Background: Tricuspid regurgitation (TR) is associated with adverse prognosis in various patient populations but currently no data is available about the prevalence and prognostic implication of TR in ST-segment elevation myocardial infarction (STEMI) patients. We investigated the possible implication of TR among STEMI patients. Methods: We conducted a retrospective study of STEMI patients undergoing primary percutaneous coronary intervention (PCI), and its relation to major clinical and echocardiographic parameters. Patients records were assessed for the prevalence and severity of TR, its relation to the clinical profile, key echocardiographic parameters, in-hospital outcomes, and long-term mortality. Patients with previous myocardial infarction or known previous TR were excluded. Results: The study included 1071 STEMI patients admitted between September 2011 and May 2016 (age 61 ± 13 years; predominantly male). A total of 205 patients (19%) had mild TR while another 32 (3%) had moderate or greater TR was 3% (n = 32). Patients with significant TR demonstrated worse echocardiographic parameters, more likely to have in-hospital complications and had higher long-term mortality (28% vs. 6%; p<0.001). Following adjustment for significant clinical and echocardiographic parameters, mortality hazard ratio (HR) of at least moderate to severe TR remained significant (2.44; 95% CI, 1.06-5.6; P = .036) for patients with moderate-severe TR. Conclusions: Among STEMI patients after primary PCI, the presence of moderate-severe TR was independently associated with adverse outcomes and significantly lower survival rate. Keywords: Tricuspid Regurgitation; ST-segment elevation myocardial infarction; percutaneous coronary intervention; cardiac intensive care unit; cardiac intensive care unit; echocardiography; valvular regurgitation.