open access

Vol 14, No 6 (2007)
Original articles
Published online: 2007-10-10
Submitted: 2013-01-14
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Cardiac rupture risk estimation in patients with acute myocardial infarction treated with percutaneous coronary intervention

Ewa Markowicz-Pawlus, Jerzy Nożyński, Agnieszka Sędkowska, Piotr Jarski, Michał Hawranek, Witold Streb, Teresa Zielińska, Lech Poloński, Zbigniew Kalarus
Cardiol J 2007;14(6):538-543.

open access

Vol 14, No 6 (2007)
Original articles
Published online: 2007-10-10
Submitted: 2013-01-14

Abstract

Background: Cardiac rupture (CR) is a common cause of death following acute myocardial infarction (AMI). Despite improvements in AMI treatment, the frequency of CR remains considerable and in most cases leads to death. The aim of the study was to define the independent prognostic CR risk factors of AMI in patients treated with percutaneous coronary intervention (PCI).
Methods: A total of 4,200 AMI patients treated by PCI were studied retrospectively. Two hundred and seventy patients who had died of AMI were examined. In all cases CR was confirmed in post-mortem examination. Results: Cardiac rupture occurred in 49 patients (18.1%). In the CR group, 24.4% patients received thrombolysis and 22.6% in the non-CR group (p = NS). The following characteristics were associated with a higher rate of CR in univariable analysis: age (70.3 ± 3.2 vs. 65.2 ± ± 9.9; p < 0.001), female (75.0% vs. 60.2%; p < 0.001), prior cardiac event and absence of myocardial infarction history (61.2% vs. 40.2%; p < 0.05 and 14.2% vs. 33.4%; p < 0.05), presence of QS complex in first ECG (75.5% vs. 52.0%, p < 0.05) and multiple coronary heart disease (75.5% vs. 61.5%, p < 0.05), and long time from onset of symptoms to thrombolysis and to PCI (8.1 ± 2.8 vs. 4.7 ± 2.3 hours, p < 0.001 and 9.0 ± 5.5 vs. 4.5 ± 3.2 hours, p < 0.001). In the multivariable analysis, independent predictors of CR were: age (OR: 1.1; 95% CI: 1.02-1.19; p = 0.01); female gender (OR: 0.2; 95% CI: 0.07-0.52; p = 0.001); time from onset of symptoms to PCI (OR: 1.15; 95% CI: 1.07-1.47; p = 0.003).
Conclusions: Old age, female gender and long time from onset of symptoms to AMI treatment (independent of previous fibrinolysis) are independent factors of CR in PCI patients. (Cardiol J 2007; 14: 538-543).

Abstract

Background: Cardiac rupture (CR) is a common cause of death following acute myocardial infarction (AMI). Despite improvements in AMI treatment, the frequency of CR remains considerable and in most cases leads to death. The aim of the study was to define the independent prognostic CR risk factors of AMI in patients treated with percutaneous coronary intervention (PCI).
Methods: A total of 4,200 AMI patients treated by PCI were studied retrospectively. Two hundred and seventy patients who had died of AMI were examined. In all cases CR was confirmed in post-mortem examination. Results: Cardiac rupture occurred in 49 patients (18.1%). In the CR group, 24.4% patients received thrombolysis and 22.6% in the non-CR group (p = NS). The following characteristics were associated with a higher rate of CR in univariable analysis: age (70.3 ± 3.2 vs. 65.2 ± ± 9.9; p < 0.001), female (75.0% vs. 60.2%; p < 0.001), prior cardiac event and absence of myocardial infarction history (61.2% vs. 40.2%; p < 0.05 and 14.2% vs. 33.4%; p < 0.05), presence of QS complex in first ECG (75.5% vs. 52.0%, p < 0.05) and multiple coronary heart disease (75.5% vs. 61.5%, p < 0.05), and long time from onset of symptoms to thrombolysis and to PCI (8.1 ± 2.8 vs. 4.7 ± 2.3 hours, p < 0.001 and 9.0 ± 5.5 vs. 4.5 ± 3.2 hours, p < 0.001). In the multivariable analysis, independent predictors of CR were: age (OR: 1.1; 95% CI: 1.02-1.19; p = 0.01); female gender (OR: 0.2; 95% CI: 0.07-0.52; p = 0.001); time from onset of symptoms to PCI (OR: 1.15; 95% CI: 1.07-1.47; p = 0.003).
Conclusions: Old age, female gender and long time from onset of symptoms to AMI treatment (independent of previous fibrinolysis) are independent factors of CR in PCI patients. (Cardiol J 2007; 14: 538-543).
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Keywords

cardiac rupture; acute myocardial infarction; risk factors

About this article
Title

Cardiac rupture risk estimation in patients with acute myocardial infarction treated with percutaneous coronary intervention

Journal

Cardiology Journal

Issue

Vol 14, No 6 (2007)

Pages

538-543

Published online

2007-10-10

Bibliographic record

Cardiol J 2007;14(6):538-543.

Keywords

cardiac rupture
acute myocardial infarction
risk factors

Authors

Ewa Markowicz-Pawlus
Jerzy Nożyński
Agnieszka Sędkowska
Piotr Jarski
Michał Hawranek
Witold Streb
Teresa Zielińska
Lech Poloński
Zbigniew Kalarus

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