Risk factors for cardiac rupture after acute ST-segment elevation myocardial infarction during the percutaneous coronary intervention era: a retrospective case-control study

Abstract

Background: In percutaneous coronary intervention (PCI) era, more clinically valuable risk factors are still needed to determine the occurrence of cardiac rupture (CR). Therefore, we aimed to provide evidence for the early identification of CR in ST-segment elevation myocardial infarction (STEMI).Methods: A total of 22,016 consecutive patients with STEMI admitted to Cangzhou Central Hospital and Tianjin Chest Hospital from January 2013 to July 2021 were retrospectively included, among which 195 patients with CR were included as CR group. From the rest 21,820 STEMI patients without CR, 390 patients at a ratio of 1:2 were included as the control group. A total of 66 patients accepted PCI in the CR group, and 132 patients who accepted PCI in the control group at a ratio of 1:2 were included. The status of first medical contact, laboratory examinations, and PCI characteristics were recorded. Multivariate logistic regression analysis was used to investigate the risk factors related to CR.Results: There was a higher proportion of patients with myocardial infarction (MI) in the high lateral wall in the CR group (23.6% vs. 8.2%, P<0.001). The proportion of single lesions was lower in the CR group

Can we predict cardiac rupture in patients with ST-segment elevation myocardial infarction?

“…In this issue of the Journal of Thoracic Disease , Xu et al ( 16 ) examined various clinical and angiographic variables associated with CR in a retrospective analysis of 22,016 STEMI patients admitted to two hospitals in China between 2013 and 2021. CR occurred in 195 patients (0.9%) who were compared with 390 controls.…”

Mechanical complications of ST segment elevation myocardial infarction: are they tangible?

“…Xu et al ( 14 ) focused on cardiac rupture (CR) which was specified as free wall rupture, ventricular septal rupture, and papillary muscle rupture. They were able to collect more than 20,000 patients’ clinical data and divided them into two groups (CR group and control group).…”

“…However, causative investigation regarding mortality after successful PCI is relatively sparse with matters pertaining to mechanical complications. Xu et al (14) focused on cardiac rupture (CR) which was specified as free wall rupture, ventricular septal rupture, and papillary muscle rupture. They were able to collect more than 20,000 patients' clinical data and divided them into two groups (CR group and control group).…”

Cardiac rupture after ST-elevation myocardial infarction (STEMI): a ‘Stitch’ in time?

“…In this issue of the journal, Xu et al aim to identify risk factors for CR in their patient population by describing nearly 200 patients with CR out of a total of 22,016 patients with STEMI and comparing their characteristics with 390 STEMI patients who did not have CR ( 5 ). In this study, 66 patients with CR accepted PCI as a management option for STEMI.…”