Document Detail


Factors related to heart rupture in acute coronary syndromes in the Global Registry of Acute Coronary Events.
MedLine Citation:
PMID:  20231153     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
AIMS: To determine the incidence and factors associated with heart rupture (HR) in acute coronary syndrome (ACS) patients.
METHODS AND RESULTS: Among 60 198 patients, 273 (0.45%) had HR (free wall rupture, n = 118; ventricular septal rupture, n = 155). Incidence was 0.9% for ST-segment elevation myocardial infarction (STEMI), 0.17% for non-STEMI, and 0.25% for unstable angina. Hospital mortality was 58 vs. 4.5% in patients without HR (P < 0.001). The incidence was lower in STEMI patients with primary percutaneous coronary intervention (PCI) than in those without (0.7 vs. 1.1%; P = 0.01), but primary PCI was not independently related to HR in adjusted analysis (P = 0.20). Independent variables associated with HR included: ST-segment elevation (STE)/left bundle branch block; ST-segment deviation; female sex; previous stroke; positive initial cardiac biomarkers; older age; higher heart rate; systolic blood pressure/30 mmHg decrease. Conversely, previous MI and the use of low-molecular-weight heparin and beta-blockers during first 24 h were identified as protective factors for HR.
CONCLUSION: The incidence of HR is low in patients with ACS, although its incidence is probably underestimated. Heart rupture occurs more frequently in ACS with STE and is associated with high hospital mortality. A number of variables are independently related to HR.
Authors:
José López-Sendón; Enrique P Gurfinkel; Esteban Lopez de Sa; Giancarlo Agnelli; Joel M Gore; Phillippe Gabriel Steg; Kim A Eagle; Jose Ruiz Cantador; Gordon Fitzgerald; Christopher B Granger;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-15
Journal Detail:
Title:  European heart journal     Volume:  31     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1449-56     Citation Subset:  IM    
Affiliation:
Cardiology Department, Hospital Universitario La Paz, Paseo de la Castellana 261, 28036 Madrid, Spain. jlsendon@terra.es
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Comment In:
Eur Heart J. 2010 Jun;31(12):1433-5   [PMID:  20406736 ]

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