Reperfusion therapy was associated with a significantly lower incidence of late cardiac free wall rupture compared to conventional therapy (0.4% vs. 1.5%; p<0.05) following acute myocardial infarction.
Cohort (n=1,329)
Does reperfusion therapy prevent cardiac free wall rupture in patients with acute myocardial infarction?
Reperfusion therapy, particularly when successful, significantly reduces the risk of late-onset cardiac free wall rupture following acute myocardial infarction.
Absolute Event Rate: 1.7% vs 2.7%
To investigate the pathophysiology of cardiac free wall rupture (cardiac rupture) following acute myocardial infarction (AMI), and to clarify whether reperfusion therapy prevents cardiac rupture, 1,329 cases of AMI (conventional therapy group: 807 cases and reperfusion therapy group: 533 cases) were studied retrospectively. The overall incidence of cardiac rupture was 2.3% (2.7% in the conventional therapy group vs. 1.7% in the reperfusion therapy group). Patients with cardiac rupture were divided into two subgroups according to the time interval from the onset of AMI to cardiac rupture (early rupture less than or equal to 72 h and late rupture greater than or equal to 4 days). The indices of initial evolution of AMI was a significant risk of early cardiac rupture. The reperfusion therapy group showed significantly lower incidence of late rupture (0.4 vs. 1.5% in conventional therapy group; p less than 0.05). The incidence of cardiac rupture in the unsuccessful reperfusion therapy group was higher than that of the successful group (5.9% of 118 cases vs. 0.5% of 404 cases; p less than 0.05). It is concluded that the etiology of cardiac rupture following AMI cannot be explained by any single factor. Early rupture depends on the initial evolution of AMI, and early reperfusion and collateral flow prevent the late onset cardiac rupture.
Nakamura et al. (Wed,) conducted a cohort in Acute myocardial infarction (AMI) (n=1,329). Reperfusion therapy vs. Conventional therapy was evaluated on Cardiac free wall rupture. Reperfusion therapy was associated with a significantly lower incidence of late cardiac free wall rupture compared to conventional therapy (0.4% vs. 1.5%; p<0.05) following acute myocardial infarction.