Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Vessel Disease, Beijing, China.
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Vessel Disease, Beijing, China.
Heart Lung Circ. 2021 Jul;30(7):978-985. doi: 10.1016/j.hlc.2020.11.013. Epub 2021 Jan 22.
This study was performed to assess long-term survival and identify risk factors for acute myocardial infarction in patients complicated with ventricular septal rupture (VSR).
A retrospective analysis of 116 patients with post-infarction VSR (PI-VSR) hospitalised in Beijing Anzhen Hospital from January 2008 to February 2019 was performed. The independent risk factors for in-hospital mortality were assessed using multivariate analysis with a logistic regression model. The Kaplan-Meier method and log-rank test were carried out for long-term survival in the surgery group.
The overall in-hospital mortality rate was 47.4%. Logistic regression analysis revealed that age (p<0.05), female sex (p<0.05), no surgical repair (p<0.05), liver dysfunction (p<0.05), high heart rate (p<0.05), and low platelet count (PLT; p<0.05) were independent risk factors for in-hospital mortality. The 1-year mortality rate was lower in the surgery group than in the medical treatment group (18.3% vs 84.5%; p<0.005). During the mean follow-up of 5.2±5.1 years (median, 1.3 years), the actuarial survival rates of these patients at 5 and 10 years were 72.3% and 43.2%, respectively.
The overall in-hospital mortality rate remained high. The independent risk factors for in-hospital mortality associated with PI-VSR were age, female sex, no surgical repair, liver dysfunction, tachycardia, and low PLT level. The 1-year mortality and long-term outcomes of patients treated with surgery were significantly better than those of patients who were treated conservatively.
本研究旨在评估并发室间隔破裂（VSR）的急性心肌梗死患者的长期生存情况并确定其相关危险因素。
回顾性分析 2008 年 1 月至 2019 年 2 月期间在北京安贞医院住院的 116 例梗死后 VSR（PI-VSR）患者。采用多因素逻辑回归模型对住院期间死亡的独立危险因素进行评估。采用 Kaplan-Meier 方法和对数秩检验对手术组的长期生存情况进行分析。
总体住院死亡率为 47.4%。Logistic 回归分析显示，年龄（p<0.05）、女性（p<0.05）、未行手术修复（p<0.05）、肝功能异常（p<0.05）、心率增快（p<0.05）和血小板计数降低（PLT；p<0.05）是住院期间死亡的独立危险因素。手术组的 1 年死亡率低于药物治疗组（18.3% vs 84.5%；p<0.005）。在平均 5.2±5.1 年（中位数为 1.3 年）的随访期间，这些患者的 5 年和 10 年累积生存率分别为 72.3%和 43.2%。
总体住院死亡率仍然较高。与 PI-VSR 相关的住院死亡独立危险因素包括年龄、女性、未行手术修复、肝功能异常、心动过速和血小板计数降低。手术治疗患者的 1 年死亡率和长期预后明显优于保守治疗患者。
