Strong predictive value of TIMI risk score analysis for in-hospital and long-term survival of patients with right ventricular infarction

Background While right ventricular myocardial infarction is associated with increased in-hospital morbidity and mortality, prognostic risk factors for in-hospital and long-term mortality are poorly defined. Objectives To evaluate the prognostic value of TIMI (Thrombolysis in Myocardial Infarction) risk score analysis in patients with right ventricular myocardial infarction (RVI). Design Retrospective analysis of a community population. Setting Mayo Clinic Coronary Care Unit. Patients One hundred and two patients with RVI from 580 consecutive patients from Rochester, Minnesota admitted to the Coronary Care Unit with acute inferior or lateral wall myocardial infarction from January 1988 through March 1998. Measurement Combined TIMI risk score analysis with in-hospital and long-term mortality. Results In-hospital morbidity (RVI: 54.9% vs non-RVI: 22-2%; P<0.001) and mortality (RVI: 21.6% vs non-RVI: 6.9%; P<0.001) were increased in patients with RVI. The TIMI risk score predicted risk (per one point increase in TIMI score) for in-hospital mortality (OR 1.23, 95% CI 1.02-1.51, P=0.037) and long-term mortality (OR 1.57, 95% CI 1.25-1.96, P<0.001). Patients with RVI whose TIMI risk score was greater than or equal to4 had significantly worse long-term survival compared to those patients with RVI and TIMI score <4 (P=0.006). Conclusions In-hospital morbidity and mortality, and long-term mortality are increased by right ventricular infarction and can be accurately predicted by the initial TIMI risk score.