Clinical characteristics of recent death in patients with acute myocardial infarction complicated with cardiac rupture
10.3969/j.issn.1008-9691.2017.05.008
- VernacularTitle:急性心肌梗死并发心脏破裂患者近期死亡的临床特征分析
- Author:
Mingfang LYU
1
,
2
;
510060 广东广州,广州市第八人民医院心内科
;
Ling XUE
;
Xueping YANG
;
Shaohui CHEN
;
Chuandong FU
;
Jiyan CHEN
Author Information
1. 510080 广东广州,广东省心血管病研究所,广东省冠心病防治研究重点实验室,广东省人民医院,广东省医学科学院
2. 510060 广东广州,广州市第八人民医院心内科
- Keywords:
Acute myocardial infarction;
Cardiac rupture;
Clinical characteristics;
Diagnostic value
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2017;24(5):477-480
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics of patients with acute myocardial infarction (AMI) complicated with cardiac rupture (CR) and to explore the risk factors for the survival time of AMI combined with CR. Methods A retrospective study was conducted. The clinical data of 75 hospitalized patients with the confirmed diagnosis of AMI combined with free wall rupture (FWR) or ventricular septal rupture (VSR) admitted to Guangdong General Hospital from April 2009 to March 2015 were collected. They were divided into a survival < 30-day group (42 cases) and a survival ≥ 30-day (33 cases) group, and their clinical characteristics were analyzed. Receiver operating characteristic curve (ROC curve) was drawn, and the predictive value of each indicator for the patient's 30-day survival time was analyzed. Results The number of female patients (25 cases vs. 0 case) and the number of patients without diabetes (36 cases vs. 21 cases) in the survival < 30-day group were significantly higher than those in survival ≥ 30-day group (all P < 0.05). Therefore, both female and without diabetes were risk factors for the recent death of AMI complicated with CR. In the survival ≥ 30-day group, the number of patients with right coronary artery (RCA) lesions and immediately undergoing early percutaneous coronary intervention therapy (PCI) was significantly higher than that in survival < 30-day group (11 cases vs. 4 cases, P < 0.05). Therefore, the RCA lesion and immediately undergoing early PCI therapy was a recent survival protective factor. ROC curve analysis showed that AMI female and combined with diabetes and lesions in RCA had a certain predictive value for survival time of the patients, the area under ROC curve (AUC) and 95% confidence interval (95%CI) were 0.798 (0.696-0.899), 0.592 (0.542-0.743) and 0.647 (0.500-0.794) respectively, sensitivity and specificity were 34.6%, 16.1% and 42.3% and 12.9% respectively, all P < 0.05. Conclusions Women and without diabetes are the risk factors of recent death of AMI complicated by CR, and in patients with AMI complicated with CR and the involved lesion being RCA, PCI therapy should be performed as early as possible that may elevate the 30-day survival rate for the patients.
