OBJECTIVETo analyze the clinical characteristics of patients with acute myocardial infarction (AMI) complicated by free wall rupture (FWR) and to define the independent risk factors for FWR.

METHODSClinical and angiographic data of 6192 AMI patients admitted to our department between January 1995 and January 2010 were retrospectively reviewed, FWR was confirmed in 43 patients by post-mortem examination. Multivariate logistic regression analysis was performed to identify risk factors for FWR.

RESULTSRupture occurred at a median of 3.58 days after symptom onset. Risk factors associated with FWR were older age, female gender, delayed hospital admission, hypertension at admission and increased serum creatine level. Although patients with FWR had more single-vessel disease, their in-hospital mortality was very high (97.7%). Undue physical efforts were documented in 41.9% patients with FWR.

CONCLUSIONOld age, female gender and prolonged time from the onset of symptoms to hospital, hypertension and high level of serum creatine at admission are independent factors of FWR.