Methods
A retrospective, single-center observational study was performed at the Tel-Aviv Sourasky Medical Center, a tertiary referral hospital with a 24/7 primary PCI service, as previously described 10.
We evaluated 2139 consecutive patients admitted between September 2011 and May 2016 to the cardiac intensive care unit (CICU) with the diagnosis of acute STEMI. We excluded patients with a missing record of tricuspid valve echocardiographic evolution (n=847), as well as patients with previous myocardial infarction (n=196) and known previous TR (n=25). The patient selection process is shown in Figure 1. The final cohort consisted of 1071 patients whose baseline demographic, cardiovascular history, clinical risk factors, treatment characteristics, and laboratory results were retrieved from their hospital electronic medical files. Diagnosis of STEMI was established in accordance with published guidelines including typical chest pain history, diagnostic electrocardiographic changes, and serial elevation of cardiac biomarkers 11. Primary PCI was performed in patients with symptoms ≤ 12 hours in duration as well as in patients with symptoms lasting 12-24 hours if pain consisted at the time of admission. Symptom duration was defined as the time from symptom onset (usually chest pain or discomfort) to ER/catheterization laboratory admission. Assessment of survival following hospital discharge was determined from computerized records of the population registry bureau. The study protocol was approved by the local institutional ethics committee.