Early cardiac rupture - A possible complication of thrombolytic and antithrombotic therapy

We investigated the survival benefit conferred by thrombolytic therapy versus any paradoxical increase in early deaths due to cardiac rupture. Of 350,755 acute myocardial infarction patients enrolled at 1,073 hospitals, 122,243 received thrombolytic therapy and 228,243 did not. In-hospital mortality rates for the overall study population, those not treated with thrombolytics, and those thus treated were 10.4%, 12.9%, and 5.9%, respectively. Although the incidence of cardiac rupture was low, it was responsible for a relatively large proportion of in-hospital deaths. Death from rupture was accelerated in patients given thrombolytic therapy, with a clustering of events within 24 hours of drug administration. Despite the early risk, death rates were comparatively low in thrombolytic-treated patients on each of the first 30 days. Cardiac rupture may represent an early hemorrhagic complication of thrombolytic (a(nd adjunctive antithrombotic) therapy.

Duke Scholars

Author Richard Clinton Becker Medicine, Cardiology