Key result
STEMI is linked to higher cardiac rupture rates than NSTEMI.
Why the study?
This study was conducted to analyze the risk factors of cardiac rupture in patients with acute myocardial infarction.
Observational (n=10,284)
No
Identifies key clinical and laboratory risk factors for cardiac rupture in acute myocardial infarction to guide preventive management.
Answers are grounded in this paper and cite their sources.
May aid risk stratification for post-AMI rupture; hypothesis-generating and requires prospective validation before practice change.
Objective: To analyze the risk factors of cardiac rupture in patients with acute myocardial infarction. Methods: Clinical data were analyzed from 10 284 acute myocardial infarction patients admitted to Beijing Anzhen Hospital from January 2012 to March 2015. Cardiac rupture occurred in 81 patients, including 67 patients of acute left ventricular free wall rupture and 14 patients of ventricular septal defect, were retrospectively analyzed. Binary logistics regression analysis was performed to analyze the risk factors of cardiac rupture. Results: Incidence of cardiac rupture was significantly higher in patients with ST-segment elevation myocardial infarction than in patients with non-ST-segment elevation myocardial infarction (1.5%(70/4 724) vs. 0.2%(11/5 560), P<0.01). Binary logistic regression analysis showed that age (OR=0.827, 95%CI 0.726-0.941, P<0.01), recurrent myocardial infarction during hospital(OR=0.001, 95%CI 0.000-0.418, P<0.05), systolic blood pressure(OR=1.114, 95%CI 1.029-1.206, P<0.01), left anterior descending artery lesion (OR=0.003, 95%CI 0.000-0.334, P<0.05), lower hemoglobin(OR=1.129, 95%CI 1.051-1.212, P<0.01), serum total protein (OR=1.453, 95%CI 1.070-1.971, P<0.05), and serum magnesium level (OR=0.000, 95%CI 0.000-0.001, P<0.01) were associated with cardiac rupture. Conclusion: Older age, recurrent myocardial infarction, lower systolic blood pressure, left anterior descending artery lesion, lower serum hemoglobin, lower serum total protein, and higher serum magnesium level are risk factors of cardiac rupture and these factors should be carefully managed to prevent the occurrence of cardiac rupture.
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Liu et al. (2016) conducted an observational in Acute myocardial infarction (n=10,284). ST-segment elevation myocardial infarction and clinical risk factors (older age, recurrent MI, lower SBP, LAD lesion, lower hemoglobin, lower total protein, higher magnesium) vs. Non-ST-segment elevation myocardial infarction / patients without cardiac rupture was evaluated on Incidence of cardiac rupture (acute left ventricular free wall rupture or ventricular septal defect) (OR 0.827, 95% CI 0.726-0.941, p=<0.01). STEMI had higher cardiac rupture rates than NSTEMI, associated with age, recurrent MI, SBP, LAD lesion, hemoglobin, total protein, and magnesium.
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