title: Effect of reperfusion therapy on cardiac rupture after myocardial infarction in Japanese.
abstract: BACKGROUND
  Cardiac rupture after acute myocardial infarction (AMI) is unpredictable and almost always fatal, so the present study reviewed all the clinical characteristics of patients with cardiac rupture to determine if its occurrence can be predicted.
  
  
  RESULTS
  The clinical characteristics of 1,296 consecutive AMI patients from January 1992 to February 2002 were retrospectively evaluated using multi-logistic analysis. Cardiac rupture occurred in 45 patients (3.5%), comprising left ventricular free wall rupture (n=23), ventricular septal perforation (n=20) and papillary muscle rupture (n=2). Early-phase rupture (within 72 h after AMI onset) was associated with anterior infarction. Of the 45 patients who experienced ruptures, 24 (53.3%) survived to discharge; 21 (46.6%) of the 45 ruptures occurred after admission. Successful reperfusion therapy was performed within 24 h for 840 patients. The incidence of rupture was significantly lower for reperfused patients than for non-reperfused patients (0.6% vs 3.5%, respectively; p<0.01). Peak C-reactive protein concentration was a reliable predictor of late-phase rupture (p=0.01), but not of early-phase rupture.
  
  
  CONCLUSIONS
  Reperfusion therapy appears to aid in the prevention of cardiac rupture, especially late-phase rupture.
authors.affiliation: Cardiovascular Division, First Department of Integrated Medicine, Omiya Medical Center, Jichi Medical School, Saitama, Japan.
authors.forename: Nahoko
authors.initials: N
authors.lastname: Ikeda
authors.forename: Takanori
authors.initials: T
authors.lastname: Yasu
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kubo
authors.forename: Taishi
authors.initials: T
authors.lastname: Hirahara
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tsuruya
authors.forename: Mikihisa
authors.initials: M
authors.lastname: Fujii
authors.forename: Muneyasu
authors.initials: M
authors.lastname: Saito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000628:therapy*; D015425:Myocardial Reperfusion; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D002097:C-Reactive Protein