ABSTRACT
Objective:
To
analysis the
risk factors of early
death and long-term outcomes of
myocardial infarction complicated with
ventricular septal rupture.
Methods:
A total of 135
patients with
myocardial infarction complicated with
ventricular septal rupture in
Beijing Anzhen
Hospital from January 2008 to December 2020 were retrospectively analyzed.According to the
survival or
death within 30 days after
ventricular septal rupture, the
patients were divided into the early
survival group(n=71)and the early
death group(n=64). The clinical characteristics of the two groups were observed, and the
risk factors for early
death group were analyzed.The long-term outcomes of the
surgery group(n=69)and the non-
surgery group(n=66)was analyzed.
Results:
The early mortality rate of
patients with
myocardial infarction complicated with
ventricular septal rupture was 47.4%(64/135). Univariate
analysis showed that age,
sex,
white blood cell count,
platelet count,
C-reactive protein level, left ventricular end-diastolic diameter, abnormal
liver function, pulmonary
infection, no
surgery repair and Killip grade ≥3 were associated with early
death as compared with the early
survival group(all P<0.05). Multivariate
regression analysis showed that no
surgery repair( OR=16.103, 95% CI 4.400-58.930, P<0.001)and Killip≥3 grade( OR=9.014, 95% CI 2.506-32.428, P=0.001)and abnormal
liver function( OR=5.171, 95% CI 1.388-19.264, P=0.014)were independent
risk factors for early
death in
patients with
myocardial infarction complicated with
ventricular septal rupture.During follow-up of 1.0 to 11.8(median 3.2)years, the 2-year and 10-year
cumulative survival rates were significantly higher in the
surgery group than in the non-
surgery group(76.7% vs.16.7%, P<0.001; 73.1% vs.16.7%, P<0.001).
Conclusions:
No surgical repair, Killip grade ≥3 and abnormal
liver function are independent
risk factors for early
death in
patients with
myocardial infarction complicated with
ventricular septal rupture.The long-term outcomes of surgical
treatment for
myocardial infarction complicated with
ventricular septal rupture is good.