Dynamic Changes and Prognostic Impact of Ischemic Mitral Regurgitation in Recurrent Myocardial Infarction

BACKGROUND: The prognostic impact of ischemic mitral regurgitation (IMR) in recurrent myocardial infarction (MI) remains poorly defined. This study evaluated dynamic changes in IMR during recurrent MI and determined prognostic implications. METHODS AND RESULTS: We retrospectively reviewed 4,091 patients who underwent primary percutaneous coronary intervention for acute MI between May 2008 and July 2022. Of these patients, 88 experienced a second MI and underwent transthoracic echocardiography at 3 time points: before recurrent MI, at onset, and at discharge. IMR severity was assessed using mean vena contracta width. Logistic regression was used to determine predictors of persistent IMR, and Cox analysis was used to evaluate 5-year adverse outcomes (a composite of all-cause death, heart failure hospitalization, and third MI). IMR worsened at the onset of recurrent MI and remained elevated at discharge (P