Clinical characteristics and prognosis differences between isolated right and left ventricular myocardial infarction in the Chinese population: a retrospective study

Yuanyuan Chen; Chunyan Weng; Junru Wu; Yan Tang; Zhengxin Li; Qing Wen; Xuejing Sun; Mingxing Wu; Zhiliu Peng; Xiying Luo; Hong Yuan; Yao Lu; Wei Huang; Jingjing Cai

doi:10.7717/peerj.14959

Clinical characteristics and prognosis differences between isolated right and left ventricular myocardial infarction in the Chinese population: a retrospective study

PeerJ. 2023 Feb 28:11:e14959. doi: 10.7717/peerj.14959. eCollection 2023.

Authors

Yuanyuan Chen^#¹, Chunyan Weng^#¹, Junru Wu¹, Yan Tang¹, Zhengxin Li¹, Qing Wen¹, Xuejing Sun¹, Mingxing Wu², Zhiliu Peng², Xiying Luo³, Hong Yuan⁴, Yao Lu⁴, Wei Huang¹, Jingjing Cai^{1

4}

Affiliations

¹ Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
² Department of Cardiology, Xiangtan Central Hospital, Xiangtan, Hunan, China.
³ Department of Cardiology, The First Affiliated Hospital, University of South China, Hengyang, Hunan, China.
⁴ The Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.

^# Contributed equally.

Abstract

Background and aims: Acute myocardial infarction (AMI) is divided into left ventricular myocardial infarction (LVMI) and right ventricular myocardial infarction (RVMI) according to the regions of myocardial ischemic necrosis. Clinical characteristics, treatment strategies, and prognosis differences between isolated RVMI and LVMI have not been well characterized. This study aimed to explore this difference of patients with isolated RVMI and LVMI.

Methods: This retrospective cohort study included 3,506 patients hospitalized with coronary angiography diagnosed type 1 myocardial infarction (MI). Characteristics of admission and treatment strategies were compared in patients with isolated RVMI and LVMI. COX proportional hazards models with and without inverse probability of treatment weighting (IPTW) adjustment were performed to estimate the difference in all-cause and cardiovascular mortality between the two groups.

Results: In this retrospective study, we found the frequency of isolated RVMI was significantly lower in the population than that of isolated LVMI (406 (11.6%) vs 3,100 (88.4%)). Patients with isolated RVMI have similar age, sex, and comorbidities to the patients with isolated LVMI. However, patients with isolated RVMI have lower heart rate and blood pressure, but higher rates of cardiogenic shock and atrioventricular block. It is noteworthy that patients with isolated RVMI are more likely to be complicated with the multivessel lesion. Patients with isolated RVMI have lower risk of all-cause mortality (HR 0.36; 95% CI [0.24-0.54], p < 0.001) and cardiovascular mortality (HR 0.37; 95% CI [0.22-0.62], p < 0.001) than patients with isolated LVMI.

Conclusions: This study showed that patients with isolated RVMI and LVMI have similar baseline characteristics. However, the clinical manifestations were different in the isolated RVMI and LVMI patients. This study revealed a better prognosis of isolated RVMI patients compared to isolated LVMI, which indicates the ischemic region could be considered in AMI risk stratification models for better assessment of risk for adverse clinical events.

Keywords: Acute myocardial infarction; Inverse probability of treatment weighting; Left ventricular myocardial infarction; Mortality; Right ventricular myocardial infarction.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anterior Wall Myocardial Infarction*
East Asian People
Humans
Myocardial Infarction*
Myocardium
Prognosis
Retrospective Studies

Grants and funding

This study was supported by the Natural Science Foundation of China 82170436, 81870171 (to Jingjing Cai), 81770403, 81974054 (to Hong Yuan), the National Key Research and Development Projects 2019YFF0216305 (to Jingjing Cai), and 2016YFC0900802 (to Hong Yuan). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.