Effect of Hypertension on Myocardial Rupture after Acute Myocardial Infarction

Christensen, Danis J.; Ford, Marilyn H.; Reading, James; Castle, C. Hilmon

doi:10.1378/chest.72.5.618

Cited by 33 publications

(10 citation statements)

References 22 publications

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“…High blood pressure could play an important role in the development of CR since it dramatically increases intracavitary pressures and shear stress force against the necrotic area during myocardial contraction, leading to a tear . In fact, studies performed several decades ago have reported an association between high blood pressure and an increased incidence of CR . Importantly, along with other studies, the present study also demonstrated that hypertension ceased to be significantly associated with CR in the most recent period.…”

Section: Discussionsupporting

confidence: 75%

Trends in the Clinical and Pathological Characteristics of Cardiac Rupture in Patients With Acute Myocardial Infarction Over 35 Years

Honda

Asaumi

Yamane

et al. 2014

JAHA

124

114

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BackgroundThere is little known about whether the clinical and pathological characteristics and incidence of cardiac rupture (CR) in patients with acute myocardial infarction (AMI) have changed over the years.Methods and ResultsThe incidence and clinical characteristics of CR were investigated in patients with AMI, who were divided into 3 cohorts: 1977–1989, 1990–2000, and 2001–2011. Of a total of 5699 patients, 144 were diagnosed with CR and 45 survived. Over the years, the incidence of CR decreased (1977–1989, 3.3%; 1990–2000, 2.8%; 2001–2011, 1.7%; P=0.002) in association with the widespread adoption of reperfusion therapy. The mortality rate of CR decreased (1977–1989, 90%; 1990–2000, 56%; 2001–2011, 50%; P=0.002) in association with an increase in the rate of emergent surgery. In multivariable analysis, first myocardial infarction, anterior infarct, female sex, hypertension, and age >70 years were significant risk factors for CR, whereas impact of hypertension on CR was weaker from 2001 to 2011. Primary percutaneous coronary intervention (PPCI) was a significant protective factor against CR. In 64 autopsy cases with CR, myocardial hemorrhage occurred more frequently in those who underwent PPCI or fibrinolysis than those who did not receive reperfusion therapy (no reperfusion therapy, 18.0%; fibrinolysis, 71.4%; PPCI, 83.3%; P=0.001).ConclusionsWith the development of medical treatment, the incidence and mortality rate of CR have decreased. However, first myocardial infarction, anterior infarct, female sex, and old age remain important risk factors for CR. Adjunctive cardioprotection against reperfusion‐induced myocardial hemorrhage is emerging in the current PPCI era.

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Section: Discussionsupporting

confidence: 75%

Trends in the Clinical and Pathological Characteristics of Cardiac Rupture in Patients With Acute Myocardial Infarction Over 35 Years

Honda

Asaumi

Yamane

et al. 2014

JAHA

124

114

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“…In this respect, the significantly lower blood pressure attained 24 hours after admission during the last three 6-year intervals in which ␤-blockers were used might be an argument in favor of their protective effect. 11,33 In contrast, 2 other investigations have disputed such a preventive role, 12,13 although they included only 25 12 and 14 cases 13 of CR. To further compound the issue, observations from a recent large clinical trial of STEMI patients have even called into question the overall survival benefit of ␤-blockers in the acute phase.…”

Section: Effects Of Medical Treatmentmentioning

confidence: 99%

Changes in Hospital Mortality Rates in 425 Patients With Acute ST-Elevation Myocardial Infarction and Cardiac Rupture Over a 30-Year Period

et al. 2008

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Background-Possible changes in the incidence and outcome of cardiac rupture in patients with ST-elevation myocardial infarction over a long period of time have not been investigated. Methods and Results-The incidence of cardiac rupture in ST-elevation myocardial infarction patients and its mortality rate were investigated during a 30-year period divided into 5 intervals (1977 to 1982, 1983 to 1988, 1989 to 1994, 1995 to 2000, and 2001 to 2006

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“…It has been shown that a severely damaged myocardium is par ticularly susceptible to rhythm disturbances [8], Rupture of the free wall of the left ventri cle is reported in 1-5% of all myocardial infarctions [4,13]. In a medicolegal necropsy series, rupture was revealed in 5% of sudden pre-hospital cardiac deaths [24].…”

Section: Discussionmentioning

confidence: 99%

In-Hospital Death from Ischaemic Heart Disease

Rissanen¹,

Helin²,

Rehnberg³

et al. 1982

Cardiology

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The clinical course and the clinical and pathological factors were studied in a series of 112 in-hospital patients who died of acute myocardial infarction. A necropsy was performed in 101 cases. 44% of the victims were concluded to have been past the possibility of recovery at the time of admission, as the treatment of early ventricular fibrillation or asystole did not lead to a satisfactory result, or as a refractory heart failure or shock dominated from admission to death. Resuscitations due to early ventricular fibrillation were performed in the emergency department mainly on patients living near the hospital. On the other hand, an early heart failure was more frequent among those whose transit distance was over 15 km. Prior use of β-receptor blockers seemed to protect against early complications. The cardiac functions of the remaining patients were normal or could be normalized at the beginning of the hospitalization. The great majority of them were later lost as a result of extensive damage of the myocardium leading to a refractory heart failure and some due to a rupture caused by infarction (8%) or due to embolic complications (10%). Only 11 patients (10%) succumbed to late ventricular fibrillation without heart failure, rupture, or embolism. The cardiac disease revealed by the necropsy was more severe in patients with a refractory heart failure than in those who died of late ventricular fibrillation or rupture without a preceding heart failure. Various arrhythmias were frequent during the hospitalization. 74% of the dysrhythmias were preceded or followed by symptoms of a heart failure.

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Effect of Hypertension on Myocardial Rupture after Acute Myocardial Infarction

Cited by 33 publications

References 22 publications

Trends in the Clinical and Pathological Characteristics of Cardiac Rupture in Patients With Acute Myocardial Infarction Over 35 Years

Trends in the Clinical and Pathological Characteristics of Cardiac Rupture in Patients With Acute Myocardial Infarction Over 35 Years

Changes in Hospital Mortality Rates in 425 Patients With Acute ST-Elevation Myocardial Infarction and Cardiac Rupture Over a 30-Year Period

In-Hospital Death from Ischaemic Heart Disease

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