What question did this study set out to answer?

To evaluate the clinical progression, timing, and influence of coronary reperfusion therapies on cardiac free wall rupture following acute myocardial infarction.

January 1, 2002Journal of Nippon Medical SchoolOpen Access

Riport on Experiments and Clinical Cases. Clinical Course, Timing of Rupture and Relationship with Coronary Recanalization Therapy in 77 Patients with Ventricular Free Wall Rupture Following Acute Myocardial Infarction.

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Population

77 patients with cardiac free wall rupture following acute myocardial infarction out of a total of 3,284 AMI…

Design

Cohort

Authors

KTKeiji TanakaRIKEN Center for Brain Science NSNaoki SatoHeart Failure & Transplant MYMasahiro YasutakeKyushu University

Discussion

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Implication

PCI-era management was associated with lower post-MI FWR rates; extends prior observations but leaves causality and practice change open.

Key Points

To evaluate the clinical progression, timing, and influence of coronary reperfusion therapies on cardiac free wall rupture following acute myocardial infarction.
Retrospective cohort analysis of 3,284 patients with acute myocardial infarction admitted to a coronary care unit across a 28-year span.
Identification and categorization of 77 patients with ventricular free wall rupture into abrupt-onset or oozing-onset subtypes.
Evaluation of rupture timing, clinical complications, temporal trends across treatment eras (pre-1981 vs. post-1988 PCI era), and intervention survival.
Ventricular free wall rupture occurred in 2.3% of patients (77/3,284), with 59.7% of ruptures occurring on Day 1, and overall incidence dropped from 2.7% before 1981 to 1.1% after 1988 (r=-0.519, P=0.0056).
Rupture presentation was abrupt in 66.2% (51/77) and oozing in 33.8% (26/77), with female sex, cardiogenic shock, prior thrombolysis, and survival rates significantly higher in the oozing group.
Overall survival was 10.4% (8/77), with successful rescue achieved via emergency surgical repair in the operating room, bedside pericardiotomy, or pericardial drainage paired with blood pressure control.

Structured PICO

Population

77 patients with cardiac free wall rupture (FWR) following acute myocardial infarction (AMI) out of a total of 3,284 AMI patients admitted to a single CCU over 28 years, mean age 69.8 years, 61.0% male.

Outcome

Incidence of FWR, clinical course, timing of rupture, and survival ratehard clinical

The introduction of PCI for acute myocardial infarction is associated with a significant decrease in the incidence of ventricular free wall rupture, and early recognition with emergency surgery may improve survival in oozing-type ruptures.

Cite This Study

Tanaka et al. (2002) studied this question.

synapsesocial.com/papers/6a882e9dbc5f9fd513bbf744 https://doi.org/10.1272/jnms.69.481

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Riport on Experiments and Clinical Cases. Clinical Course, Timing of Rupture and Relationship with Coronary Recanalization Therapy in 77 Patients with Ventricular Free Wall Rupture Following Acute Myocardial Infarction.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Riport on Experiments and Clinical Cases. Clinical Course, Timing of Rupture and Relationship with Coronary Recanalization Therapy in 77 Patients with Ventricular Free Wall Rupture Following Acute Myocardial Infarction.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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