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Somuncu MU, Tatar FP, Kalayci B, Avci A, Gudul NE, Serbest NG, Demir AR, Can M. Role of N-terminal pro-B-type natriuretic peptide and troponin T in predicting right ventricular recovery in myocardial infarction. Horm Mol Biol Clin Investig 2021; 43:27-33. [PMID: 34791860 DOI: 10.1515/hmbci-2021-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 11/02/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The determinants of right ventricular (RV) recovery after successful revascularization in ST-elevation myocardial infarction (STEMI) patients are not clear. Besides, the relationship between Troponin T (TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and improvement in RV function is also unknown. This study hypothesizes that a lower TnT and NT-proBNP level would be associated with RV recovery. METHODS One hundred forty-eight STEMI patients were included in our study. Echocardiography were performed before and 12-18 weeks after discharge. Patients were divided into three groups according to the changes in tricuspid annular plane systolic excursion (TAPSE) as 53 patients with ≥10% change, 41 patients with 1-9% change, and 54 patients ≤0% change. RV recovery was accepted as ≥10% TAPSE improvement and the predictors of RV recovery were investigated. RESULTS RV recovery was detected in 35.8% of the patients. Low baseline left ventricular ejection fraction (OR: 0.91 [0.84-0.98], p=0.023), NT-proBNP (OR: 0.93 [0.89-0.98], p=0.014), TnT (OR: 0.84 [0.68-0.93], p=0.038), inferior myocardial infarction (OR: 2.66 [1.10-6.40], p=0.028), wall motion score index ratio (OR: 0.93 [0.88-0.97], p=0.002) and post-percutaneous coronary intervention TIMI flow 3 (OR: 5.84 [1.41-24.22], p=0.015) were determined as independent predictors of RV recovery. Being in the high TnT group 4.2 times, and being in the high NT-proBNP group 5.3 times could predict the failure to achieve RV recovery. Furthermore, when high TnT level was combined with high NT-proBNP level, the odds ratio of failure to achieve RV recovery was the highest (OR: 8.03 [2.59-24.89], p<0.001). CONCLUSIONS Lower TnT and lower NT-proBNP level was associated with better improvement in RV function in STEMI patients.
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Affiliation(s)
- Mustafa Umut Somuncu
- Department of Cardiology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Fatih Pasa Tatar
- Department of Cardiology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Belma Kalayci
- Department of Cardiology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Ahmet Avci
- Department of Cardiology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Naile Eris Gudul
- Department of Cardiology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Nail Guven Serbest
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Ali Riza Demir
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Murat Can
- Department of Biochemistry, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
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Jimenez-Juan L, Ben-Dov N, Goncalves Frazao CV, Tan NS, Singh SM, Dorian P, Angaran P, Oikonomou A, Kha LCT, Roifman I, Chacko B, Connelly KA, Kirpalani A, Deva D, Yan AT. Right Ventricular Function at Cardiac MRI Predicts Cardiovascular Events in Patients with an Implantable Cardioverter-Defibrillator. Radiology 2021; 301:322-329. [PMID: 34402663 DOI: 10.1148/radiol.2021210246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Right ventricular ejection fraction (RVEF) is an independent predictor of death and adverse cardiovascular outcomes in patients with various cardiac conditions. Purpose To investigate whether RVEF, measured with cardiac MRI, is a predictor of appropriate shock or death in implantable cardioverter-defibrillator (ICD) recipients for primary and secondary prevention of sudden cardiac death. Materials and Methods This retrospective, multicenter, observational study included patients who underwent cardiac MRI before ICD implantation between January 2007 and May 2017. Right ventricular end-diastolic and end-systolic volumes and RVEF were measured with cardiac MRI. The primary end point was a composite of all-cause mortality or appropriate ICD shock. The secondary end point was all-cause mortality. The association between RVEF and primary and secondary outcomes was evaluated by using multivariable Cox regression analysis. Potential interactions were tested between primary prevention, ischemic cause, left ventricular ejection fraction (LVEF), and RVEF. Results Among 411 patients (mean age ± standard deviation, 60 years; 315 men) during a median follow-up of 63 months, 143 (35%) patients experienced an appropriate ICD shock or died. In univariable analysis, lower RVEF was associated with greater risks for appropriate ICD shock or death and for death alone (log-rank trend test, P = .003 and .005 respectively). In multivariable Cox regression analysis adjusting for age at ICD implantation, LVEF, ICD indication (primary vs secondary), ischemic heart disease, and late gadolinium enhancement, RVEF was an independent predictor of the primary outcome (hazard ratio [HR], 1.21 per 10% lower RVEF; 95% CI: 1.04, 1.41; P = .01) and all-cause mortality (HR, 1.25 per 10% lower RVEF; 95% CI: 1.01, 1.55; P = .04). No evidence of significant interactions was found between RVEF and primary or secondary prevention (HR, 1.11 ± 0.17 [standard deviation]; P = .49), ischemic heart disease (HR, 1.02 ± 0.15; P = .78), and LVEF (HR, 0.91 ± 0.8; P = .29). Conclusion Right ventricular ejection fraction measured with cardiac MRI was a predictor of appropriate implantable cardioverter-defibrillator shock or death. © RSNA, 2021 See also the editorial by Nazarian and Zghaib in this issue.
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Affiliation(s)
- Laura Jimenez-Juan
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Nissan Ben-Dov
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Caio V Goncalves Frazao
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Nigel S Tan
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Sheldon M Singh
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Paul Dorian
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Paul Angaran
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Anastasia Oikonomou
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Lan-Chau T Kha
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Idan Roifman
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Binita Chacko
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Kim A Connelly
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Anish Kirpalani
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Djeven Deva
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Andrew T Yan
- From the Departments of Radiology (L.J.J., A.K., D.D.) and Cardiology (N.S.T., P.D., P.A., K.A.C., A.T.Y.), St Michael's Hospital, 30 Bond St, Toronto, ON, Canada M5B 1W8; and Departments of Radiology (C.V.G.F., A.O., L.C.T.K., B.C.) and Cardiology (N.B.D., S.M.S., I.R.), Sunnybrook Health Sciences Centre, Toronto, Canada
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Roifman I, Qiu F, Connelly KA, Wright GA, Farkouh M, Jimenez-Juan L, Wijeysundera HC. Validation of billing code combinations to identify cardiovascular magnetic resonance imaging scans in Ontario, Canada: a retrospective cohort study. BMJ Open 2018; 8:e021370. [PMID: 30297345 PMCID: PMC6194470 DOI: 10.1136/bmjopen-2017-021370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Cardiovascular magnetic resonance (CMR) imaging is the gold-standard test for the assessment of heart function. Despite its importance, many jurisdictions lack specific billing codes that can be used to identify patient receipt of CMR in administrative databases, limiting the ability to perform 'big data' CMR studies. Our objective was to identify the optimal billing code combination to identify patients who underwent CMR using administrative data in Ontario. DESIGN Retrospective cohort study. SETTING Quaternary care academic referral centre in Ontario, Canada. PARTICIPANTS We tested all billing code combinations in order to identify the optimal one to determine receipt of CMR. The reference gold standard was a list of all cardiothoracic magnetic resonance scans performed at Sunnybrook Health Sciences Centre between 1 January 2014 and 31 December 2016, verified by chart audit. We assessed the diagnostic performance (accuracy, sensitivity, specificity, positive predictive value and negative predictive value) for all code combinations. RESULTS Our gold-standard cohort consisted of 2339 thoracic MRIs that were performed at Sunnybrook Health Sciences Centre from 1 January 2014 to 31 December 2016. Of these, 2139 (91.5%) were CMRs and 200 (8.5%) were chest MRIs. We identified the most accurate billing combination for the determination of patient receipt of CMR. This combination resulted in an accuracy of 95.3% (95% CI 94.4% to 96.2%), sensitivity of 97.4% (95% CI 96.6% to 98.1%), specificity of 86.4% (95% CI 83.1% to 89.6%), positive predictive value of 96.9% (95% CI 96.1% to 97.6%) and negative predictive value of 88.4% (95% CI 85.4% to 91.5%). CONCLUSIONS Our study is the first to verify the ability to accurately identify patient receipt of CMR using administrative data, facilitating more robust population-based CMR studies in the future.
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Affiliation(s)
- Idan Roifman
- Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Medicine, Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada
- Department of Medicine, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Feng Qiu
- Department of Medicine, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Kim A Connelly
- Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Medicine, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Graham A Wright
- Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Michael Farkouh
- Department of Medicine, Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada
- Department of Medicine, Toronto General Hospital, Toronto, Ontario, Canada
| | - Laura Jimenez-Juan
- Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Harindra C Wijeysundera
- Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Medicine, Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada
- Department of Medicine, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
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Roifman I, Ghugre NR, Vira T, Zia MI, Zavodni A, Pop M, Connelly KA, Wright GA. Assessment of the longitudinal changes in infarct heterogeneity post myocardial infarction. BMC Cardiovasc Disord 2016; 16:198. [PMID: 27741939 PMCID: PMC5064965 DOI: 10.1186/s12872-016-0373-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 09/30/2016] [Indexed: 11/17/2022] Open
Abstract
Background Infarct heterogeneity, as assessed by determination of the peri-infarct zone (PIZ) by cardiac magnetic resonance imaging, has been shown to be an independent predictor for the development of cardiac arrhythmias and mortality post myocardial infarction (MI). The temporal evolution of the PIZ post MI is currently unknown. Thus, the main objective of our study was to describe the temporal evolution of the PIZ over a 6 month time period in contemporarily managed ST elevation myocardial infarction (STEMI) patients. Further, given the poor prognosis associated with microvascular obstruction (MVO) post STEMI, we sought to compare the temporal evolution of the PIZ in patients with and without MVO. We hypothesized that patients with MVO would show a relative persistence of PIZ over time when compared to those without MVO. Methods Twenty-one patients post primary percutaneous coronary intervention were enrolled and treated with evidence based therapy. Each patient had three cardiac MRI scans at 48 h, 3 weeks and 6 months post infarction. Repeated Measures Analysis of Variance (ANOVA) was used to assess the evolution of core infarct size and peri-infarct zone size across the three time frames. Results The patients in this study were predominantly male, with ~40 % LAD territory infarction and a mean LVEF of 46 ± 7 %. Core infarct size and PIZ size both decreased significantly across the three time frames. The presence of microvascular obstruction (MVO), a known adverse prognostic factor, influenced PIZ size. Both patients with and without MVO had a significant reduction in core infarct size over time. Patients with MVO did not have a significant change in PIZ size over time (11.9 ± 6.8 %, 12.2 ± 7.5 %, 10.7 ± 6.6 % p = 0.77). In contrast, non-MVO patients did have a significant decrease in PIZ size over time (7.0 ± 5.5 %, 7.1 ± 6.5 %, 2.7 ± 2.6 %, p = 0.01). Conclusions Peri-infarct zone size, like core infarct size, varies depending upon the timing of measurement. Patients with MVO displayed a persistence of the PIZ over time.
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Affiliation(s)
- Idan Roifman
- Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada.
| | - Nilesh R Ghugre
- Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Tasnim Vira
- Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada
| | - Mohammad I Zia
- Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada
| | - Anna Zavodni
- Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada.,Division of Cardiothoracic Imaging, Department of Medical Imaging, Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, ON, Canada
| | - Mihaela Pop
- Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Kim A Connelly
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute of St. Michael's Hospital, The University of Toronto, Toronto, ON, Canada
| | - Graham A Wright
- Sunnybrook Research Institute, Schulich Heart Program, Sunnybrook Health Sciences Centre and the University of Toronto, 2075 Bayview Avenue, room M 315b, Toronto, ON, M4N-3M5, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
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Roifman I, Ghugre N, Zia MI, Farkouh ME, Zavodni A, Wright GA, Connelly KA. Diabetes is an independent predictor of right ventricular dysfunction post ST-elevation myocardial infarction. Cardiovasc Diabetol 2016; 15:34. [PMID: 26892325 PMCID: PMC4759780 DOI: 10.1186/s12933-016-0352-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is estimated to become the 7th leading cause of death by 2030. Right ventricular dysfunction (RVD) complicating ST elevation myocardial infarction (STEMI) is independently associated with a higher mortality; however the relationship between DM and RVD is currently unknown. The purpose of this study was to determine whether DM is an independent predictor for the presence of right ventricular dysfunction (RVD) post STEMI. METHODS 106 patients post primary PCI for STEMI were enrolled in the study. Cardiac MRI was performed within 48-72 h after admission in order to assess ventricular function. Statistical analysis consisted initially of descriptive statistics including Chi square, Fisher's exact, or the Wilcoxon rank sum as appropriate. Subsequently, logistic regression analysis was performed to determine independent predictors of RVD. RESULTS The median age in the study was 58 years (IQR 53, 67). 30 % of the patients had diabetes. Of 99 patients for which RV data was available, 40 had RVD and 59 did not. Patients with DM were significantly more likely to have RVD when compared to those without diabetes (45 vs 22 %, p = 0.03). There was no significant difference in age, hypertension, smoking status, dyslipidemia, serum creatinine or peak CK levels between the two groups. After adjusting for other factors, presence of DM remained an independent predictor for the presence of RV dysfunction (OR 2.78, 95 % CI 1.12, 6.87, p = 0.03). Amongst diabetic patients, those with HbA1C ≥ 7 % had greater odds of having RVD vs those with HbA1C < 7 % (OR 5.58 (1.20, 25.78), p = 0.02). CONCLUSIONS The presence of DM conferred an approximately threefold greater odds of being associated with RVD post STEMI. No other major cardiovascular risk factors were independently associated with the presence of RVD.
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Affiliation(s)
- Idan Roifman
- Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
| | - Nilesh Ghugre
- Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. .,Physical Sciences Platform, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. .,Department of Medical Biophysics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
| | - Mohammad I Zia
- Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
| | - Michael E Farkouh
- Division of Cardiology, University Health Network, University of Toronto, Toronto, ON, Canada. .,Keenan Biomedical Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
| | - Anna Zavodni
- Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
| | - Graham A Wright
- Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. .,Physical Sciences Platform, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. .,Department of Medical Biophysics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
| | - Kim A Connelly
- Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. .,Keenan Biomedical Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
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