Coronary disease & ACS

Right Ventricular to Pulmonary Arterial Uncoupling Is Associated With 1-Year Mortality in ST-Segment Elevation Myocardial Infarction

JACC Cardiovasc IntervPublished Post hoc analysis of a retrospective cohort study

Primary result · 1-year all-cause mortalityResult — go to the resultHazard ratio 12.60 95% CI 4.49–35.40

Authors' conclusion

RV-PA uncoupling (TAPSE/sPAP ratio < 0.405 mm/mm Hg) is an independent predictor of 1-year all-cause mortality in these patients, aiding in early risk stratification.

Study context

Population
STEMI patients undergoing primary PCI, 2014–2023median follow-up 4.2 years
Participants
973 patients
Comparison
RV-PA uncoupling vs preserved RV-PA coupling
Primary endpoint
All-cause mortality
Follow-up
1 year
Methodological detailsderivation and validation cohorts, external validation cohort
  • Derivation and validation cohorts
  • External validation cohort

Primary result

1-year all-cause mortality

Hazard ratio

12.60

95% CI 4.49–35.40

P < 0.001

By group

RV-PA uncouplingvs Preserved RV-PA coupling
HR 12.60 (95% CI 4.49–35.40); P < 0.001

As reported in the abstract

Further findings

OutcomeTAPSE/sPAPTAPSEP value
Prediction of 1-year mortality: TAPSE/sPAP vs TAPSE alone (ROC)P = 0.018
AUC0.732 [95% CI: 0.643-0.821]0.643 [95% CI: 0.537-0.732]

Original publication

Right Ventricular to Pulmonary Arterial Uncoupling Is Associated With 1-Year Mortality in ST-Segment Elevation Myocardial Infarction. JACC Cardiovasc Interv. Published 29 January 2026. doi:10.1016/j.jcin.2025.12.003

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