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June 14, 2026Frontiers in Cardiovascular MedicineOpen Access

Risk factors, subtype profiles, and outcomes of cardiac rupture after acute myocardial infarction: a case-control study

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Why the study?

Cardiac rupture is a fatal mechanical complication of AMI, making early identification of high-risk patients clinically important, especially in regions with delayed presentation and limited contemporary data.

Population

71 AMI patients with cardiac rupture and 213 AMI controls without mechanical complications

Comparison

Cardiac rupture cases vs AMI controls without mechanical complications

Design

Retrospective case-control study

Key result

Absence of emergency percutaneous coronary intervention was independently associated with a significantly increased risk of cardiac rupture after acute myocardial infarction (OR 8.23).

Authors

DZDan ZhangCHChaojie HuangXWXiaosu Wang

Discussion

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Member takes

Overview

May support prioritizing emergency PCI to lower rupture risk; leaves open causality in observational data.

Key Points

  • This study aims to identify risk factors and outcomes associated with cardiac rupture following acute myocardial infarction.
  • Retrospective case-control study of 71 patients with cardiac rupture and 213 controls without complications from AMI.
  • Used multivariable logistic regression to identify factors associated with cardiac rupture.
  • Evaluated subtype comparisons and in-hospital mortality correlates.
  • Patients with cardiac rupture were significantly older (69.6 years) and had longer onset-to-door times.
  • Absence of emergency PCI (OR=8.23), female sex (OR=3.41), and low albumin levels (OR=0.84) were associated with increased risk of cardiac rupture.
  • Surgical repair significantly reduced in-hospital mortality (OR=0.06).

Study Design

Type

Case-Control (n=284)

Multicenter

No

Structured PICO

P
Population
284 hospitalized adults with acute myocardial infarction, comprising 71 cases with cardiac rupture and 213 controls without mechanical complications.
O
Outcome
Occurrence of cardiac rupture after acute myocardial infarctionhard clinical

Main Result

Odds Ratio: 8.23 (95% CI 3.45–19.66)

p-value: p=<0.001

Absence of emergency PCI, Killip class III-IV, female sex, and hypoalbuminemia are independent risk factors for cardiac rupture after acute myocardial infarction, with surgical repair associated with lower in-hospital mortality.

Limitations

  • Single-center, retrospective design inherently limits generalizability
  • Susceptible to residual confounding
  • Small sample size for certain subgroups like papillary muscle rupture
  • Medication variables may reflect consequences of delayed presentation rather than independent upstream contributors
  • Retrospective, single-center design
  • Modest sample size of the VSR group and extremely small sample size of the PMR subgroup
  • Likelihood of survivor and indication bias for surgical repair
  • Near-complete separation in FWR mortality model due to high mortality rate
  • Apparent discrimination in case-control studies may be inflated by large baseline differences

Cite This Study

Zhang et al. (2026) conducted a case-control in Acute myocardial infarction (n=284). Absence of emergency percutaneous coronary intervention vs. Receipt of emergency percutaneous coronary intervention was evaluated on Occurrence of cardiac rupture after acute myocardial infarction (OR 8.23, 95% CI 3.45-19.66, p=<0.001). Absence of emergency percutaneous coronary intervention was independently associated with a significantly increased risk of cardiac rupture after acute myocardial infarction (OR 8.23).

synapsesocial.com/papers/6a2e44a3b1cc60ccdea8a2b7https://doi.org/10.3389/fcvm.2026.1827832
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