Clinical characteristics and protective factors in patients with acute myocardial infarction undergoing in-hospital myocardial free wall rupture: a single-center, retrospective analysis.
acute myocardial infarction
clinical characteristics
myocardial free wall rupture
protective factors
Journal
Journal of investigative medicine : the official publication of the American Federation for Clinical Research
ISSN: 1708-8267
Titre abrégé: J Investig Med
Pays: England
ID NLM: 9501229
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
accepted:
08
07
2019
pubmed:
1
8
2019
medline:
8
8
2020
entrez:
1
8
2019
Statut:
ppublish
Résumé
Myocardial free wall rupture (MFWR) refers to laceration of the heart ventricle or atria, which is a rare but fatal complication of acute myocardial infarction (AMI). In this study, we aim to identify the clinical characteristics and protective factors of free wall rupture after myocardial infarction. This is a single-center, retrospective observational analysis. The study screened all patients admitted to the cardiology department of the First Affiliated Hospital of Xi'an Jiaotong University between January 2013 and April 2018. The biochemical, clinical, angiographic and echocardiographic features of these patients were then collected and analyzed. Among the 5946 screened patients with AMI, 23 patients with a diagnosis of MFWR after AMI were enrolled in the present study. 18 (78.3%) patients were diagnosed with acute ST segment elevated myocardial infarction and the remaining 5 (21.7%) have acute non-ST segment elevated myocardial infarction. Early-phase MFWR happened in 12 (52.2%) and late-phase accounted for 8 (34.8%) in total. Late-phase MFWR had lower left ventricle ejection fraction value (45.8%±5.6% vs 63.0±3.8%, p<0.001) as compared with early-phase. Patients who survived from MFWR has higher ACE inhibitor/angiotensin II receptor blocker (ACEI/ARB) and β-blocker coverage in the in-hospital treatment of AMI (ACEI/ARB: 100.0% vs 35.3%, p=0.014; β-blocker: 100.0% vs 47.1%, p=0.048). The present study provides evidence for better understanding of the clinical characteristics and protective functions in MFWR after AMI. Reduced cardiac function is correlated with higher incidence of later phase free wall rupture. Higher ACEI/ARB and β-blocker coverage in the AMI treatment strategy is associated with lower MFWR incidence.
Identifiants
pubmed: 31363018
pii: jim-2019-001070
doi: 10.1136/jim-2019-001070
pmc: PMC6900210
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1097-1102Informations de copyright
© American Federation for Medical Research 2019. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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