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CLC number: R541.4

On-line Access: 2013-07-30

Received: 2012-11-08

Revision Accepted: 2013-05-03

Crosschecked: 2013-07-19

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Journal of Zhejiang University SCIENCE B 2013 Vol.14 No.8 P.736-742

http://doi.org/10.1631/jzus.B1200306


Risk of cardiac rupture after acute myocardial infarction is related to a risk of hemorrhage


Author(s):  Geng Qian, Hong-bin Liu, Jin-wen Wang, Chen Wu, Yun-dai Chen

Affiliation(s):  Department of Cardiology, Chinese People’s Liberation Army General Hospital, Beijing 100853, China

Corresponding email(s):   qiangeng9396@263.net, cyundai@126.com

Key Words:  Acute myocardial infarction (AMI), Risk factor, Hemorrhage


Geng Qian, Hong-bin Liu, Jin-wen Wang, Chen Wu, Yun-dai Chen. Risk of cardiac rupture after acute myocardial infarction is related to a risk of hemorrhage[J]. Journal of Zhejiang University Science B, 2013, 14(8): 736-742.

@article{title="Risk of cardiac rupture after acute myocardial infarction is related to a risk of hemorrhage",
author="Geng Qian, Hong-bin Liu, Jin-wen Wang, Chen Wu, Yun-dai Chen",
journal="Journal of Zhejiang University Science B",
volume="14",
number="8",
pages="736-742",
year="2013",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1200306"
}

%0 Journal Article
%T Risk of cardiac rupture after acute myocardial infarction is related to a risk of hemorrhage
%A Geng Qian
%A Hong-bin Liu
%A Jin-wen Wang
%A Chen Wu
%A Yun-dai Chen
%J Journal of Zhejiang University SCIENCE B
%V 14
%N 8
%P 736-742
%@ 1673-1581
%D 2013
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1200306

TY - JOUR
T1 - Risk of cardiac rupture after acute myocardial infarction is related to a risk of hemorrhage
A1 - Geng Qian
A1 - Hong-bin Liu
A1 - Jin-wen Wang
A1 - Chen Wu
A1 - Yun-dai Chen
J0 - Journal of Zhejiang University Science B
VL - 14
IS - 8
SP - 736
EP - 742
%@ 1673-1581
Y1 - 2013
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1200306


Abstract: 
Although cardiac rupture (CR) is a fatal mechanical complication of acute myocardial infarction (AMI), to date no predictive model for CR has been described. CR has common pathological characteristics with major bleeding. We aimed to investigate the relationship between the risk factors of major bleeding and CR. A total of 10202 consecutive AMI patients were recruited, and mechanical complications occurred in 72 patients. AMI patients without CR were chosen as control group. Clinical characteristics including bleeding-related factors were compared between the groups. The incidences of free wall rupture (FWR), ventricular septal rupture (VSR), and papillary muscle rupture (PMR) were 0.39%, 0.21%, and 0.09%, respectively, and the hospital mortalities were 92.5%, 45.5%, and 10.0%, respectively. Female proportion and average age were significantly higher in the groups of FWR and VSR than in the control group (P<0.01); higher white blood cell count and lower hemoglobin were found in all CR groups (P<0.01). Compared to the control group, patients with CR were more likely to receive an administration of thrombolysis [26.39% vs. 13.19%, P<0.05], and were less likely to be treated with primary percutaneous coronary intervention (PCI) [41.67% vs. 81.60%, P<0.05]. The major bleeding scores (integer scores) of FWR, VSR, and PMR were (17.70±7.24), (21.91±8.33), and (18.60±7.88), respectively, and were significantly higher than that of the control group (11.72±7.71) (P<0.05). A regression analysis identified age, increased heart rate, anemia, higher white blood cell count, and thrombolysis as independent risk factors of CR, most of which were major bleeding-related factors. The patients with CR have a significantly higher risk of hemorrhage compared to the group without CR. Risk of CR after AMI is related to the risk of hemorrhage.

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