Cardiac rupture during acute myocardial infarction : Autopsy study (2004–2020)

Oualha, Dorra; Abderrahim, Sarra Ben; Abdeljelil, Nouha Ben; BelHadj, Meriem; Jomâa, Sami Ben; Saadi, Said; Zakhama, Abdelfattah; Salem, Nidhal Haj

doi:10.1016/j.ancard.2023.101601

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…Many other factors were also associated with the occurrence of CR. Previous studies confirmed that age, medical history, clinical manifestations, biochemical test findings, and treatment (32)(33)(34). Qian et al (34) designed a clinical risk scoring system for predicting CR in STEMI patients.…”

Section: Discussionmentioning

confidence: 58%

Risk of cardiac rupture among elderly patients with diabetes presenting with first acute myocardial infarction

Zu,

Jin,

Zeng

et al. 2023

Front. Endocrinol.

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ObjectiveWe aimed to analyze the risk of cardiac rupture (CR) in aged diabetic patients with acute ST-segment elevated myocardial infarction (STEMI) who were followed up for one month, and analyze its independent risk factors.MethodsA total of 3063 aged patients with first onset STEMI admitted to Beijing Anzhen Hospital from January 2001 to December 2020 were retrospectively included. There were 2020 patients without diabetes mellitus (DM) and 1043 patients with DM. We used propensity scores matching (PSM) method to balance baseline exposure factors between patients with or without DM, and all were divided the DM group (1043 cases) and the non-DM group (1043 cases) after the PSM. The primary outcome was CR (the composite rate of papillary muscle rupture, ventricular septum perforation, free wall rupture), which was diagnosed based on clinical manifestations and/or echocardiographic findings. Kaplan-meier survival analyses and log-rank test was used to evaluate the risk of CR between the two groups, and Cox regression analysis was used to evaluate the independent risk factors for CR.ResultsAfter PSM, the baseline clinical data were similar between the DM and non-DM group (all P>0.05). However, level of glycated hemoglobin was significantly higher in the DM group (P<0.05). During 1 month of follow-up, there were 55 (2.64%) cases of CR, most occurred within 48h after admission (40 cases). Among the 55 cases, 11(0.53%) had papillary muscle rupture, 18(0.86%) had ventricular septum perforation, and 26(1.25%) had free wall rupture. Kaplan-meier survival analyses detected that the DM group was associated with significantly increased risk of CR (3.36% vs. 1.92%, HR=1.532, 95% CI: 1.054-2.346, P=0.030), ventricular septum perforation (1.05% vs. 0.67%, HR=1.464, 95% CI: 1.021-2.099, P=0.038) and free wall rupture (1.63% vs. 0.86%, HR=1.861, 95% CI: 1.074-3.225, P=0.027) than those in the non-DM group. Among the 2031 aged STEMI patients without CR, 144 cases (6.90%, 144/2086) died; and among the 55 patients with CR, 37 cases (1.77%, 37/2086) died due to CR. Therefore, twenty percent (20.44%, 37/181) of death was due to CR. Multivariate Cox regression analysis indicated that DM (HR=1.532, 95%CI: 1.054-2.346), age (HR=1.390, 95%CI: 1.079-1.791), female (HR=1.183, 95%CI: 1.049-1.334), troponin I (HR=1.364, 95%CI: 1.108-1.679), brain natriuretic peptide (HR=1.512, 95%CI: 1.069-2.139), revascularization (HR=0.827, 95%CI: 0.731-0.936) and β-receptor blocker (HR=0.849, 95%CI: 0.760-0.948) were independent risk factors of CR (all P<0.05).ConclusionDM as well as a few other factors, are independent determinants of CR. CR is not a rare event among the aged STEMI patients and twenty percent of deaths are due to CR. However, large sample-sized studies are warranted to confirm these findings.

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Section: Discussionmentioning

confidence: 58%

Risk of cardiac rupture among elderly patients with diabetes presenting with first acute myocardial infarction

Zu,

Jin,

Zeng

et al. 2023

Front. Endocrinol.

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“…After MI occurs, a large number of fibroblasts replace necrotic cardiomyocytes, leading to ventricular remodeling such as myocardial fibrosis and cardiac hypertrophy ( 4 ). These changes can ultimately lead to adverse events such as cardiac rupture, heart failure (HF), and sudden death due to insufficient cardiac motility ( 5 – 7 ). Although methods such as bypass grafting, percutaneous coronary intervention (PCI), and antithrombotic drugs are available for MI treatment, they can only reduce the severity of CAD to a certain extent.…”

Section: Introductionmentioning

confidence: 99%

From multi-omics approaches to personalized medicine in myocardial infarction

Zhan,

Tang,

et al. 2023

Front. Cardiovasc. Med.

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Myocardial infarction (MI) is a prevalent cardiovascular disease characterized by myocardial necrosis resulting from coronary artery ischemia and hypoxia, which can lead to severe complications such as arrhythmia, cardiac rupture, heart failure, and sudden death. Despite being a research hotspot, the etiological mechanism of MI remains unclear. The emergence and widespread use of omics technologies, including genomics, transcriptomics, proteomics, metabolomics, and other omics, have provided new opportunities for exploring the molecular mechanism of MI and identifying a large number of disease biomarkers. However, a single-omics approach has limitations in understanding the complex biological pathways of diseases. The multi-omics approach can reveal the interaction network among molecules at various levels and overcome the limitations of the single-omics approaches. This review focuses on the omics studies of MI, including genomics, epigenomics, transcriptomics, proteomics, metabolomics, and other omics. The exploration extended into the domain of multi-omics integrative analysis, accompanied by a compilation of diverse online resources, databases, and tools conducive to these investigations. Additionally, we discussed the role and prospects of multi-omics approaches in personalized medicine, highlighting the potential for improving diagnosis, treatment, and prognosis of MI.

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Predictive Effect of Atypical Right Bundle Branch Block on In-Hospital Sudden Cardiac Death and Cardiac Rupture and Long-Term Prognosis in Patients with Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention

Yang,

Chen,

et al. 2024

Preprint

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Cardiac rupture during acute myocardial infarction : Autopsy study (2004–2020)

Cited by 4 publications

References 31 publications

Risk of cardiac rupture among elderly patients with diabetes presenting with first acute myocardial infarction

Risk of cardiac rupture among elderly patients with diabetes presenting with first acute myocardial infarction

From multi-omics approaches to personalized medicine in myocardial infarction

Predictive Effect of Atypical Right Bundle Branch Block on In-Hospital Sudden Cardiac Death and Cardiac Rupture and Long-Term Prognosis in Patients with Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention

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