ArticleCardiology journal2021
In-hospital outcomes of mechanical complications in acute myocardial infarction: Analysis from a nationwide Spanish database.
Article in Cardiology journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Is pulmonary hypertension protective against cardiac tamponade? A systematic review.Internal and emergency medicine · 2024Pooled it
- Outcomes with mechanical circulatory support devices among patients with mechanical complications of acute myocardial infarction.European heart journal. Acute cardiovascular care · 2025Observational
- Prediction of mechanical complications post-acute myocardial infarction in individuals with type 2 diabetes mellitus.Frontiers in medicine · 2025Article
- Development of a nomogram to predict 30-day mortality in patients with post-infarction ventricular septal rupture.Scientific reports · 2024Article
- Structural Complications Following ST-Elevation Myocardial Infarction: An Analysis of the National Inpatient Sample 2016 to 2020.Journal of cardiovascular development and disease · 2024Article
- Overview of prevalence, trends, and outcomes of post myocardial infarction mechanical complications.Annals of cardiothoracic surgery · 2022Article
- Inferior ST-Segment Elevation Can Predict In-Hospital Mortality in Patients with Anterior Myocardial Infarction Complicated by Ventricular Septal Rupture.Disease markers · 2022Article
- Trends in Ischemic Mitral Regurgitation Following ST-Elevation Myocardial Infarction Over a 20-Year Period.Frontiers in cardiovascular medicine · 2021Article
- [Mechanical complications after myocardial infarction in a National Reference Hospital].Archivos peruanos de cardiologia y cirugia cardiovascularArticle
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Authors and funding
10 authors at 7 institutions in 1 country.
Funding
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Abstract
backgroundMechanical complications represent an important cause of mortality in myocardial infarction (MI) patients. This is a nationwide study performed to evaluate possible changes in epidemiology or prognosis of these complications with current available strategies.
methodsInformation was obtained from the minimum basis data set of the Spanish National Health System, including all hospitalizations for acute myocardial infarction (AMI) from 2010 to 2015. Risk-standardized in-hospital mortality ratio was calculated using multilevel risk adjustment models.
resultsA total of 241,760 AMI episodes were analyzed, MI mechanical complications were observed in 842 patients: cardiac tamponade in 587, ventricular septal rupture in 126, and mitral regurgitation due to papillary muscle or chordae tendineae rupture in 155 (there was more than one complication in 21 patients). In-hospital mortality was 59.5%. On multivariate adjustment, variables with significant impact on in-hospital mortality were: age (OR 1.06; 95% CI 1.04-1.07; p < 0.001), ST-segment elevation AMI (OR 2.91; 95% CI 1.88-4.5; p < 0.001), cardiogenic shock (OR 2.35; 95% CI 1.66-3.32; p < 0.001), cardio-respiratory failure (OR 3.48; 95% CI 2.37-5.09; p < 0.001), and chronic obstructive pulmonary disease (OR 1.85; 95% CI 1.07-3.20; p < 0.001). No significant trends in risk-adjusted in-hospital mortality were detected (IRR 0.997; p = 0.109). Cardiac intensive care unit availability and more experience with mechanical complications management were associated with lower adjusted mortality rates (56.7 ± 5.8 vs. 60.1 ± 4.5; and 57 ± 6.1 vs. 59.9 ± 5.6, respectively; p < 0.001).
conclusionsMechanical complications occur in 3.5 per thousand AMI, with no significant trends to better survival over the past few years. Advanced age, cardiogenic shock and cardio-respiratory failure are the most important risk factors for in-hospital mortality. Higher experience and specialized cardiac intensive care units are associated with better outcomes.
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