The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index.
Risk Factors, Angiographic Patterns, and Outcomes in Patients With Ventricular Septal Defect Complicating Acute Myocardial Infarction
Abstract
Background —Ventricular septal defect (VSD) complicating acute myocardial infarction has been studied primarily in small, prethrombolytic-era trials. Our goal was to determine clinical predictors and angiographic and clinical outcomes of this complication in the thrombolytic era. Methods and Results —We compared enrollment characteristics, angiographic patterns, and outcomes (30-day and 1-year mortality) of patients enrolled in the Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries (GUSTO-I) trial with and without a confirmed diagnosis of VSD. Univariable and multivariable analyses were used to assess relations between enrollment factors and the development of VSD. In all, 84 of the 41 021 patients (0.2%) developed VSD, a smaller percentage than reported in the prethrombolytic era. The median time from symptom onset to VSD diagnosis was 1 day. Enrollment factors most associated with this complication were advanced age, anterior infarction, female sex, and no previous smoking. The infarct artery was more often the left anterior descending and more likely to be totally occluded in patients who developed VSD. Mortality at 30 days was higher in patients with VSDs than in those without this complication (73.8% versus 6.8%, P <0.001). Patients with VSDs selected for surgical repair (n=34) had better outcomes than patients treated medically (n=35; 30-day mortality, 47% versus 94%). Conclusions —Compared with historical control subjects, patients who undergo thrombolysis within 6 hours of infarction onset may have a reduced risk of later VSD. If patients develop this mechanical complication, however, it typically occurs sooner than described in the prethrombolytic era. Despite improvements in medical therapy and percutaneous and surgical techniques, mortality with this complication remains extremely high.
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Self-citationA composite view of cardiac rupture in the United States national registry of myocardial infarction
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2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction
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Self-citationAcute Myocardial Infarction in Women: A Scientific Statement From the American Heart Association
Mehta, L. S., Beckie, T. M., DeVon, H. A., Grines, C. L., Krumholz, H. M., Johnson, M. N., Lindley, K. J., Vaccarino, V., Wang, T. Y., Watson, K. E., et al. (2016) · Circulation · doi:10.1161/cir.0000000000000351 · Cited by 1,244
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JCS 2018 Guideline on Diagnosis and Treatment of Acute Coronary Syndrome
Kimura, K., Kimura, T., Ishihara, M., Nakagawa, Y., Nakao, K., Miyauchi, K., Sakamoto, T., Tsujita, K., Hagiwara, N., Miyazaki, S., et al. (2019) · Circulation Journal · doi:10.1253/circj.cj-19-0133 · Cited by 565
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Metadata
- Authors
- Crenshaw, B. S., Granger, C. B., Birnbaum, Y., Pieper, K. S., Morris, D. C., Kleiman, N. S., Vahanian, A., Califf, R. M., & Topol, E. J.
- Venue
- Circulation
- Published
- 2000-01-04
- Volume
- 101
- Issue
- 1
- Pages
- 27-32
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2095452772
- Cited by
- 773
- References
- 10
- FWCI
- 14.68
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Risk Factors, Angiographic Patterns, and Outcomes in Patients With Ventricular Septal Defect Complicating Acute Myocardial Infarction. https://app.cochat.ai/papers/10.1161/01.cir.101.1.27
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- Crenshaw, B. S., Granger, C. B., Birnbaum, Y., Pieper, K. S., Morris, D. C., Kleiman, N. S., Vahanian, A., Califf, R. M., & Topol, E. J. (2000). Risk Factors, Angiographic Patterns, and Outcomes in Patients With Ventricular Septal Defect Complicating Acute Myocardial Infarction. Circulation. https://doi.org/10.1161/01.cir.101.1.27
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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