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Factors associated with in-hospital mortality from free wall rupture after acute myocardial infarction

  • Xueying Liu
    Affiliations
    Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical Collage, Beijing, China
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  • Xiang Cui
    Affiliations
    Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Zeming Zhou
    Affiliations
    Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical Collage, Beijing, China
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  • Jingjing Xu
    Affiliations
    Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical Collage, Beijing, China
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  • Xianliang Zhou
    Affiliations
    Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical Collage, Beijing, China
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  • Weixian Yang
    Affiliations
    Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical Collage, Beijing, China
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  • Yaxin Liu
    Affiliations
    Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical Collage, Beijing, China
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  • Hanmei Li
    Correspondence
    Corresponding authors at: Fuwai Hospital, No. 167 Beilishi Street, Xicheng District, Beijing, China.
    Affiliations
    Department of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Huiqiong Tan
    Correspondence
    Corresponding authors at: Fuwai Hospital, No. 167 Beilishi Street, Xicheng District, Beijing, China.
    Affiliations
    Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical Collage, Beijing, China
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Published:October 12, 2022DOI:https://doi.org/10.1016/j.hrtlng.2022.10.002

      Highlights

      • Of the total sample, 78% had in-hospital mortality.
      • Factors associated with in-hospital mortality from free wall rupture were first reported.
      • Pericardiocentesis, pericardial effusion at admission, the acute myocardial infarction to free wall rupture time, and previous myocardial infarction were associated factors.

      Abstract

      Background

      Free wall rupture is a fatal and emergency complication of acute myocardial infarction. The factors associated with in-hospital mortality from free wall rupture remain unclear.

      Objectives

      To investigate the factors associated with in-hospital mortality from free wall rupture.

      Methods

      We performed a single-center, retrospective study. We enrolled 111 consecutive patients with free wall rupture following acute myocardial infarction who were admitted to Fuwai Hospital from January 2005 to May 2021. The primary endpoint was in-hospital death. Clinical characteristics, laboratory data, and treatment modalities associated with in-hospital mortality were analyzed.

      Results

      Eighty-seven of the 111 study participants died in hospital. Multivariate Cox regression analysis showed that pericardiocentesis (hazard ratio [HR] 0.296, 95% confidence interval [CI] 0.094–0.929, p = 0.037), pericardial effusion at admission (HR 0.083, 95% CI 0.025–0.269, p<0.001), time interval between acute myocardial infarction and free wall rupture (HR 0.670, 95% CI 0.598–0.753, p<0.001), and previous myocardial infarction (HR 0.046, 95% CI 0.010–0.208, p<0.001) were independently associated with in-hospital mortality.

      Conclusions

      Pericardiocentesis, pericardial effusion at admission, the acute myocardial infarction to free wall rupture time, and previous myocardial infarction are associated with a lower rate of in-hospital mortality from free wall rupture after acute myocardial infarction.

      Keywords

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