Factors related to heart rupture in acute coronary syndromes in the Global Registry of Acute Coronary Events.

Journal Article (Journal Article;Multicenter Study)

AIMS: To determine the incidence and factors associated with heart rupture (HR) in acute coronary syndrome (ACS) patients. METHODS AND RESULTS: Among 60 198 patients, 273 (0.45%) had HR (free wall rupture, n = 118; ventricular septal rupture, n = 155). Incidence was 0.9% for ST-segment elevation myocardial infarction (STEMI), 0.17% for non-STEMI, and 0.25% for unstable angina. Hospital mortality was 58 vs. 4.5% in patients without HR (P < 0.001). The incidence was lower in STEMI patients with primary percutaneous coronary intervention (PCI) than in those without (0.7 vs. 1.1%; P = 0.01), but primary PCI was not independently related to HR in adjusted analysis (P = 0.20). Independent variables associated with HR included: ST-segment elevation (STE)/left bundle branch block; ST-segment deviation; female sex; previous stroke; positive initial cardiac biomarkers; older age; higher heart rate; systolic blood pressure/30 mmHg decrease. Conversely, previous MI and the use of low-molecular-weight heparin and beta-blockers during first 24 h were identified as protective factors for HR. CONCLUSION: The incidence of HR is low in patients with ACS, although its incidence is probably underestimated. Heart rupture occurs more frequently in ACS with STE and is associated with high hospital mortality. A number of variables are independently related to HR.

Full Text

Duke Authors

Cited Authors

  • López-Sendón, J; Gurfinkel, EP; Lopez de Sa, E; Agnelli, G; Gore, JM; Steg, PG; Eagle, KA; Cantador, JR; Fitzgerald, G; Granger, CB; Global Registry of Acute Coronary Events (GRACE) Investigators,

Published Date

  • June 2010

Published In

Volume / Issue

  • 31 / 12

Start / End Page

  • 1449 - 1456

PubMed ID

  • 20231153

Electronic International Standard Serial Number (EISSN)

  • 1522-9645

Digital Object Identifier (DOI)

  • 10.1093/eurheartj/ehq061


  • eng

Conference Location

  • England