Branch segment occlusion with acute myocardial infarction is a risk for left ventricular free wall rupture.
BACKGROUND
Patients with acute myocardial infarction (AMI) whose culprit lesion lies in a branch of the 3 major coronary arteries have well-preserved cardiac function. A first MI with preserved cardiac function is a risk factor for left ventricular free wall rupture (LVFWR), so the aim of this study was to investigate the possible relationship between AMI with branch segment occlusion and LVFWR.


RESULTS
The 439 patients with AMI were retrospectively studied. They were divided into 2 groups: group B (n=70; segments 4 atrioventricular node artery, 4 posterior descending coronary artery, 8, 9, 10, 12, 14, or 15 according to the AHA classification), and group P (n=369; segments 1, 2, 3, 5, 6, 7, 11, or 13). Primary percutaneous coronary intervention (PCI) was more often performed in group P (75% vs 57%; P=0.0018). In-hospital mortality tended to be lower in group B (1.4% vs 6.2%; P=0.105). The incidence of LVFWR was significantly higher in group B (10.0% vs 1.6%; P=0.0002).By multivariate logistic regression analysis, 1-vessel disease, absence of primary PCI, branch segment occlusion, and age were identified as independent predictors of LVFWR.


CONCLUSIONS
The incidence of LVFWR was higher in group B and branch segment occlusion was identified as an independent predictor of LVFWR.
Ino
Yasushi
Y
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
Kubo
Takashi
T
Tomobuchi
Yoshiaki
Y
Oshika
Hiroyuki
H
Kitabata
Hironori
H
Obana
Masahiro
M
Tanimoto
Takashi
T
Takarada
Shigeho
S
Tanaka
Atsushi
A
Imanishi
Toshio
T
Okamura
Yoshitaka
Y
Akasaka
Takashi
T
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001157:Arterial Occlusive Diseases / Q000150:complications*; D003324:Coronary Artery Disease / Q000150:complications; D006341:Heart Rupture / Q000175:diagnosis* / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012306:Risk