Aim To study some specific high risk subgroups of patients with acute inferior myocardial infarction,such as right ventricular involvement and explore the clinical implication and prognosis influence of right ventricular infarction and the effect of reperfusion therapy.Methods 304 patients of acute inferior myocardial infarction were treated with reperfusion therapy or conservative therapy according to guideline and patients selection.There were 232 patients of inferior myocardial infarction without right ventricular involvement and 72 patients with right ventricular involvement.Datas were recorded including clinical features and complications.Results The incidence of complications significantly increased in patients with right ventricular infarction,which included cardiogenic shock,mechanical complications,complete atrioventricular block,ventricular fibrillation,sustained ventricular tachycardia and reinfarction.The in-hospital mortality was 8.6% in patients without right ventricular involvement and 34.7% in patients with right ventricular involvement.In patients with right ventricular involvement,the in-hospital mortality was 27.8% in reperfusion therapy group and 55.6% with conservative therapy group.Conclusions Right ventricular involvement is a high risk subgroup of acute inferior myocardial infarction,which increases in-hospital morbidity and mortality.Reperfusion therapy can improve the in-hospital outcomes of right ventricular infarction.