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dc.contributor.authorLopez-Sendon, Jose
dc.contributor.authorGurfinkel, Enrique P.
dc.contributor.authorLopez de Sa, Esteban
dc.contributor.authorAgnelli, Giancarlo
dc.contributor.authorGore, Joel M.
dc.contributor.authorSteg, Phillippe Gabriel
dc.contributor.authorEagle, Kim A.
dc.contributor.authorCantadore, Jose Ruiz
dc.contributor.authorFitzGerald, Gordon
dc.contributor.authorGranger, Christopher B.
dc.date2022-08-11T08:08:08.000
dc.date.accessioned2022-08-23T15:43:47Z
dc.date.available2022-08-23T15:43:47Z
dc.date.issued2010-06-17
dc.date.submitted2011-09-23
dc.identifier.citationEur Heart J. 2010 Jun;31(12):1449-56. Epub 2010 Mar 15. <a href="http://dx.doi.org/10.1093/eurheartj/ehq061">Link to article on publisher's site</a>
dc.identifier.issn0195-668X (Linking)
dc.identifier.doi10.1093/eurheartj/ehq061
dc.identifier.pmid20231153
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27170
dc.description.abstractAIMS: 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.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=20231153&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1093/eurheartj/ehq061
dc.subjectAcute Coronary Syndrome
dc.subjectAdrenergic beta-Antagonists
dc.subjectAdult
dc.subjectAged
dc.subjectAngina, Unstable
dc.subjectAnticoagulants
dc.subjectCohort Studies
dc.subjectFemale
dc.subjectFibrinolytic Agents
dc.subjectHeart Rupture
dc.subjectHeart Rupture, Post-Infarction
dc.subjectHeparin, Low-Molecular-Weight
dc.subjectHospital Mortality
dc.subjectHumans
dc.subjectIncidence
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMyocardial Infarction
dc.subjectYoung Adult
dc.subjectHealth Services Research
dc.titleFactors related to heart rupture in acute coronary syndromes in the Global Registry of Acute Coronary Events
dc.typeJournal Article
dc.source.journaltitleEuropean heart journal
dc.source.volume31
dc.source.issue12
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/cor_grace/10
dc.identifier.contextkey2254929
html.description.abstract<p>AIMS: To determine the incidence and factors associated with heart rupture (HR) in acute coronary syndrome (ACS) patients.</p> <p>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.</p> <p>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.</p>
dc.identifier.submissionpathcor_grace/10
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.contributor.departmentCenter for Outcomes Research
dc.source.pages1449-56


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