Heart rupture predictors in Spanish myocardial infarction patients: evaluation using propensity score analysis.

Background: The aim was to evaluate factors associated with the development of heart rupture in a Spanish registry of acute myocardial infarction (AMI) patients.

Material/methods: This was a retrospective study of cohorts, including all patients diagnosed with AMI included in the ARIAM Spanish multicenter registry. The study period was from June 1996 to December 2005. The follow-up period was limited to the time of stay in intensive care or coronary care units. Multivariate logistic regression was used to study the factors associated with the development of heart rupture. A propensity score analysis was also performed to determine the involvement of beta blockers, ACE inhibitors, and fibrinolytics in the development of heart rupture.

Results: 16,815 AMI patients were included. Heart rupture occurred in 477 (2.8%). Heart rupture was associated with female gender, older age, the absence of previous infarct, and the administration of thrombolysis, while ACE inhibitors and beta blockers acted as protective variables. The propensity score analysis showed that fibrinolysis was a variable associated with heart rupture except in the younger subgroup and in the subgroup with less delay in administration. It was also found that beta blockers and ACE inhibitors are variables providing protection against heart rupture.

Conclusions: Heart rupture is associated with older age, female gender, absence of previous infarct, and the administration of thrombolysis, while ACE inhibitors and beta blockers seem to prevent this complication.