The Role of Mitral Annular Calcification in Predicting One-Month Mortality in Patients with STEMI Undergoing Primary Percutaneous Coronary Intervention

Purpose: Numerous cardiovascular disorders have been related to mitral annular calcification (MAC). This study looked at the effects of mitral annular calcification on one-month mortality in ST-segment elevation myocardial infarction (STE-MI) patients. Methods: This single-center, retrospective observational study was carried out between 2017 and 2021. The study included 1541 patients who presented to the Dr. Siyami Ersek Hospital emergency department with a diagnosis of STE-MI and underwent primary percutaneous intervention. The patients' clinical and demographic characteristics were investigated. Images taken during percutaneous intervention using angiography were used to assess the presence of MAC in patients. According to death, the patients were split into two groups, and a statistical analysis was done. Results: The median age of 1541 STE-MI patients included in the study was 59 years (51, 68) and 78% were male. While MAC was present in 134 patients (8.7%) in the whole group, the frequency of MAC was significantly higher in the deceased compared to the survivors (19% vs. 7.8%, p<0.001). The presence of MAC (OR = 2.84, 95% CI 1.68-4.63, p<0.001) was associated with death. In multivariable analysis hypertension (OR = 1.6, 95% CI 1.02-2.54, p = 0.043), platelet count (OR = 1, 95% CI 1.00-1.01, p = 0.02), LVEF (OR = 0.98, 95% CI 0.96-) 1.00, p = 0.024) and MAC (OR = 2.68, 95% CI 1.55- 4.50, p<0.001) were found to be independent predictors of death. Conclusion: In STE-MI patients, increased one-month mortality is strongly correlated with the presence of MAC during fluoroscopic primary percutaneous intervention.