Mechanical Complications of Myocardial Infarction

Mariani, Silvia; Formica, Francesco; Paolini, Giovanni

doi:10.5772/61373

Cited by 2 publications

(4 citation statements)

References 73 publications

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“…11) Mechanical complications were defined as any spontaneous rupture of the myocardium following a myocardial infarction and were classified as a ventricular free wall rupture, ventricular septal rupture, or pupillary muscle rupture type, according to the area where the rupture occurred, and the detailed definition of each has been previously reported. 17) Echocardiography was performed upon admission for the STEMIs and when a mechanical complication was suspected at the discretion of the attending physician. The laboratory data were obtained upon admission and every 3 hours until the CK value peaked out.…”

Section: Methodsmentioning

confidence: 99%

“…We recently reported that even if patients who suffered from a mechanical complication were at a high surgical risk, if they were not particularly frail, surgical intervention improved the 30-day mortality. 17) Therefore, aggressive surgical intervention may lead to a mid-term improvement in the prognosis of the CS (+) CCLL (−) group. From another viewpoint, the prescription rate of an OMT at discharge was as high in the CS (+) CCLL (−) group as in the CS (−) groups, and the myocardial damage reflected by the peak CK level was not as large as that in the CS (+) CCLL (+) group (Table I).…”

Section: Characteristics and Prognosis In Stemi Patients With Cs With...mentioning

confidence: 99%

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Prognostic Significance of a Combination of Cardiogenic Shock and the Critical Culprit Lesion Location in ST-Elevation Myocardial Infarctions

et al. 2022

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Both cardiogenic shock (CS) and critical culprit lesion locations (CCLLs), defined as the left main trunk and proximal left anterior descending coronary artery, are associated with worse outcomes in ST-elevation myocardial infarctions (STEMIs). We aimed to examine how the combination of CS and/or CCLLs affected the prognosis in Japanese STEMI patients in the primary percutaneous coronary intervention era (PPCI-era). The subjects included 624 STEMI patients admitted to our hospital between January 2013 and April 2020. They were divided into four groups according to the combination of CS and CCLLs: CS (−) CCLL (−) group [n = 405], CS (−) CCLL (+) group [n = 150], CS (+) CCLL (−) group [n = 25], and CS (+) CCLL (+) group [n = 44].The cumulative incidences of all-cause death at 30 days and 1 year were 3.5% and 6.4% in the CS (−) CCLL (−), 3.3% and 5.6% in the CS (−) CCLL (+), 32.0% and 32.0% in the CS (+) CCLL (−), and 50.0% and 65.9% in the CS (+) CCLL (+) group, respectively. After a multivariate adjustment, the CS (+) CCLL (+) group was independently associated with all-cause death (hazard ratio: 17.00, 95% confidence interval: 7.12-40.59 versus the CS (−) CCLL (−) group). In the CS (+) CCLL (+) group, compared to years 2013-2017, the IMPELLA begun to be used (44.4% versus 0%), and intra-aortic balloon pumps significantly decreased (44.4% versus 92.3%) during years 2018-2020, while the medications upon discharge did not significantly differ. The 30-day mortality was numerically lower during years 2018-2020 than years 2013-2017 (Log-rank test, P = 0.092). In conclusion, the prognosis of STEMIs varies greatly depending on the combination of CS and CCLLs, and in particular, patients with both CS and CCLLs had the poorest prognosis during the modern PPCI-era.

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Section: Methodsmentioning

confidence: 99%

Section: Characteristics and Prognosis In Stemi Patients With Cs With...mentioning

confidence: 99%

Prognostic Significance of a Combination of Cardiogenic Shock and the Critical Culprit Lesion Location in ST-Elevation Myocardial Infarctions

et al. 2022

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“…ST-elevation depicted transmural ischemia resulting in the weakening and rupture of the septal wall. 10,36 Two out of 6 patients had RBBB.…”

Section: O N L I N E F I R S Tmentioning

confidence: 99%

“…Several studies had found that inferior MI tend to have worse outcome and higher mortality rate than other locations as it was correlated to complex type of VSD. This type could lead to extensive hemorrhage 10,36 . It is confirmed that mortality risk is higher for patients with inferior-basal defects than for those with anterior-apical defects.…”

Section: O N L I N E F I R S Tmentioning

confidence: 99%

Predicting Ventricular Septal Rupture in ST-Elevation Myocardial Infarct in Low Resource Setting: a case series

Suryono

Naesilla²,

Roestanajie³

et al. 2021

IJC

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Background: The mortality rate caused by myocardial infarct (MI) escalates in the presence of ventricular septal rupture (VSR). This article aimed to analyze clinical factors that might be valuable as predictors of VSR. Case Illustration: We found and presented six documented post-infarction VSR out of 1,613 MI cases between January 2015 to December 2019. Conclusion: Based on the analysis, clinicians should be aware of these factors as they were potential to be the predictors: advanced age, first MI, anterior location of the infarct, infranodal conduction disorder, no reperfusion treatment, high systolic blood pressure on admission, and no smoking history.

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Mechanical Complications of Myocardial Infarction

Cited by 2 publications

References 73 publications

Prognostic Significance of a Combination of Cardiogenic Shock and the Critical Culprit Lesion Location in ST-Elevation Myocardial Infarctions

Prognostic Significance of a Combination of Cardiogenic Shock and the Critical Culprit Lesion Location in ST-Elevation Myocardial Infarctions

Predicting Ventricular Septal Rupture in ST-Elevation Myocardial Infarct in Low Resource Setting: a case series

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