Impact of Right Ventricular Involvement on Bleeding and Mortality in Patients With Right Coronary Artery-Related Myocardial Infarction ― Insights From Nationwide Registry ―
Abstract
BACKGROUND: Right ventricular involvement (RVI) in acute myocardial infarction (AMI) patients is recognized as a high-risk subset. However, its impact on bleeding and mortality is not well defined in patients with right coronary artery (RCA)-related ST-segment elevation acute myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). METHODS AND RESULTS: Using data from the multicenter, prospective Japan AMI Registry including 3,411 patients, we analyzed 993 patients with RCA-related STEMI who underwent PCI. The incidence of all-cause mortality and major bleeding, defined as Bleeding Academic Research Consortium Type 3 or 5, was compared between patients with and without RVI. RVI was present in 9% (n=92) of patients. During a 12-month follow-up, RVI was independently associated with an increased risk of all-cause mortality (adjusted hazard ratio [HR] 2.05; 95% confidence interval [CI] 1.11-3.79) and major bleeding (adjusted HR 2.28; 95% CI 1.13-4.57) in Cox analysis, although this bleeding association was attenuated in adjusted competing-risk analysis (adjusted subdistribution HR 1.87; 95% CI 0.90-3.89). Among patients with RVI, those who experienced major bleeding had a significantly higher risk of death (HR 4.88, 95% CI 1.63-14.58). CONCLUSIONS: In patients with RCA-related STEMI treated with PCI, RVI was associated with increased mortality and appeared to be associated with a higher risk of bleeding.
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BibTeX
@article{honda2026impact,
title = {{Impact of Right Ventricular Involvement on Bleeding and Mortality in Patients With Right Coronary Artery-Related Myocardial Infarction ― Insights From Nationwide Registry ―}},
author = {Satoshi Honda and Kensaku Nishihira and Misa Takegami and Sunao Kojima and Yasuhide Asaumi and Mike Saji and Jun Yamashita and Kohei Wakabayashi and Kiyoshi Hibi and Jun Takahashi and Yasuhiko Sakata and Morimasa Takayama and Tetsuya Sumiyoshi and Teruo Noguchi and Hisao Ogawa and Satoshi Yasuda and on behalf of the JAMIR Investigators},
journal = {Circulation Journal},
year = {2026},
month = sep,
doi = {10.1253/circj.cj-26-0028},
url = {https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-26-0028/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Impact of Right Ventricular Involvement on Bleeding and Mortality in Patients With Right Coronary Artery-Related Myocardial Infarction ― Insights From Nationwide Registry ―
AU - Satoshi Honda
AU - Kensaku Nishihira
AU - Misa Takegami
AU - Sunao Kojima
AU - Yasuhide Asaumi
AU - Mike Saji
AU - Jun Yamashita
AU - Kohei Wakabayashi
AU - Kiyoshi Hibi
AU - Jun Takahashi
AU - Yasuhiko Sakata
AU - Morimasa Takayama
AU - Tetsuya Sumiyoshi
AU - Teruo Noguchi
AU - Hisao Ogawa
AU - Satoshi Yasuda
AU - on behalf of the JAMIR Investigators
PY - 2026
DA - 2026/09/17
JO - Circulation Journal
DO - 10.1253/circj.cj-26-0028
UR - https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-26-0028/_article
AB - BACKGROUND: Right ventricular involvement (RVI) in acute myocardial infarction (AMI) patients is recognized as a high-risk subset. However, its impact on bleeding and mortality is not well defined in patients with right coronary artery (RCA)-related ST-segment elevation acute myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). METHODS AND RESULTS: Using data from the multicenter, prospective Japan AMI Registry including 3,411 patients, we analyzed 993 patients with RCA-related STEMI who underwent PCI. The incidence of all-cause mortality and major bleeding, defined as Bleeding Academic Research Consortium Type 3 or 5, was compared between patients with and without RVI. RVI was present in 9% (n=92) of patients. During a 12-month follow-up, RVI was independently associated with an increased risk of all-cause mortality (adjusted hazard ratio [HR] 2.05; 95% confidence interval [CI] 1.11-3.79) and major bleeding (adjusted HR 2.28; 95% CI 1.13-4.57) in Cox analysis, although this bleeding association was attenuated in adjusted competing-risk analysis (adjusted subdistribution HR 1.87; 95% CI 0.90-3.89). Among patients with RVI, those who experienced major bleeding had a significantly higher risk of death (HR 4.88, 95% CI 1.63-14.58). CONCLUSIONS: In patients with RCA-related STEMI treated with PCI, RVI was associated with increased mortality and appeared to be associated with a higher risk of bleeding.
SN - 1347-4820
SN - 1346-9843
ER -