%0 Journal Article %A Anita Persson %A Marianne Hartford %A Johan Herlitz %A Thomas Karlsson %A Torbjørn Omland %A Kenneth Caidahl %T Long-term prognostic value of mitral regurgitation in acute coronary syndromes %D 2010 %R 10.1136/hrt.2010.203059 %J Heart %P 1803-1808 %V 96 %N 22 %X Objectives To determine the additional prognostic value of mitral regurgitation (MR) over B-type natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and clinical characteristics in patients with acute coronary syndromes (ACS).Design Long-term follow-up in a prospective ACS cohort with Doppler-assessed MR, echocardiographically-determined LVEF and plasma BNP levels by ELISA.Setting Single-centre university hospital.Patients 725 patients with ACS.Main outcome measures Death and readmission for congestive heart failure.Results During a median follow-up of 98 months, 235 patients (32%) died. Significant MR (grade >1 of 4) was found in 90 patients (12%). In a multivariate model including MR grade >1, LVEF <0.40 and BNP >373 pg/ml (75th percentile), MR was significantly associated with long-term mortality (HR 2.28, 95% CI 1.67 to 3.12; p<0.0001). When also adjusting for conventional risk factors, MR remained significantly associated with mortality (HR 1.53, 95% CI 1.06 to 2.19; p=0.02), as well as with congestive heart failure (HR 2.08, 95% CI 1.29 to 3.35; p=0.003).Conclusions MR is common in patients with ACS, provides independent risk information and should be taken into account in the evaluation of the long-term prognosis. %U https://heart.bmj.com/content/heartjnl/96/22/1803.full.pdf