Table 1.
Characteristics of VSR patients stratified by different managements.
| Characteristics | Medical management (without VSR repair) (n = 78) | Percutaneous TCC management (n = 31) | Surgical management (n = 18) | P value |
|---|---|---|---|---|
| Age, (years) | 68.5 ± 8.7 | 64.0 ± 8.96 | 63.1 ± 5.53 | 0.008 |
| Male sex, n (%) | 36 (46.2) | 19 (61.3) | 12 (66.7) | 0.162 |
| Cardiogenic shock, n (%) | 63 (80.8) | 4 (12.9) | 9 (50.0) | <0.001 |
| AMI to VSR time, (days) | 3.2 ± 2.4 | 3.8 ± 2.8 | 3.5 ± 2.6 | 0.448 |
| *VSR Type, n (%) | 0.400 | |||
| Acute | 28 (36.4) | 8 (25.8) | 5 (27.8) | |
| Subacute | 22 (28.6) | 8 (25.8) | 6 (33.3) | |
| Late presentation | 27 (35.1) | 15 (48.4) | 7 (38.9) | |
| Size of main VSR, (mm) | 9.3 ± 5.3 | 10.9 ± 5.01 | 15.7 ± 6.16 | <0.001 |
| Single VSR, n (%) | 56 (82.4) | 26 (83.9) | 17 (94.4) | 0.449 |
| VSR location, n (%) | 0.332 | |||
| Apical | 62 (79.5) | 20 (64.5) | 11 (66.7) | |
| Anterior | 9 (11.5) | 6 (19.4) | 3 (16.7) | |
| Posterior | 7 (9.0) | 5 (16.1) | 4 (22.2) | |
| VSR to operation time (days) | – | 20.0 [14.0–27.0] | 14.0 [11.75–20.25] | 0.018 |
| Acute phase repair, n (%) | – | 8 (25.8) | 10 (55.6) | |
| Elective repair, n (%) | 23 (74.2) | 8 (44.4) | ||
| MI information | – | |||
| Infarct territory, n (%) | 0.953 | |||
| Anterior | 63 (81.8) | 25 (80.6) | 14 (77.8) | |
| Inferior | 11 (14.3) | 5 (16.1) | 4 (22.2) | |
| Others | 3 (3.9) | 1 (3.2) | – | |
| Prior Fibrinolysis therapy, n (%) | 13 (16.7) | 2 (6.5) | 3 (16.7) | 0.369 |
| CAG data, n (%) | <0.001 | |||
| Negative | 1 (5.3) | 3 (9.7) | 1 (5.6) | |
| LAD | 16 (84.2) | 20 (64.5) | 10 (55.6) | |
| RCA | 2 (10.5) | 4 (12.9) | 3 (16.7) | |
| LCX | – | 1 (3.2) | – | |
| Triple vessel disease | – | 2 (6.5) | 2 (11.1) | |
| Culprit artery treatment, n (%) | <0.001 | |||
| PCI | 16 (79.5) | 15 (48.4) | 4 (22.2) | |
| CABG | – | 1 (3.2) | 9 (50.0) | |
| PCI+CABG | – | 1 (3.2) | 2 (11.1) | |
| In-hospital stays, (days) | 5.0 [2.0–11.0] | 27.0 [19.0–32.0] | 31.5 [22.7–40.3] | <0.001 |
| Comorbidities, n(%) | ||||
| Current smoker | 16 (20.5) | 11 (35.5) | 5 (27.8) | 0.260 |
| Current drinker | 11 (14.1) | 5 (16.1) | 3 (16.7) | 0.942 |
| Hypertension | 42 (53.8) | 16 (51.6) | 11 (61.1) | 0.807 |
| Diabetes mellitus | 25 (32.1) | 7 (22.6) | 7 (38.9) | 0.453 |
| History of MI | 5 (6.4) | 1 (3.2) | 2 (11.1) | 0.550 |
| History of stroke/TIA | 16 (20.5) | 1 (3.2) | 4 (22.2) | 0.072 |
| Hyperlipidemia | 8 (10.3) | 2 (6.5) | 3 (16.7) | 0.526 |
| Examinations | ||||
| Heart rate, (b.p.m.) | 92.6 ± 19.6 | 92.1 ± 15.4 | 93.2 ± 15.3 | 0.977 |
| SBP, (mmHg) | 105.9 ± 18.3 | 108.5 ± 14.7 | 114.3 ± 16.5 | 0.176 |
| DBP, (mmHg) | 68.9 ± 15.7 | 71.1 ± 9.8 | 74.1 ± 11.4 | 0.344 |
| LVEF, (%) | 49.6 ± 10.1 | 52.7 ± 9.3 | 52.2 ± 8.9 | 0.299 |
| NT-pro BNP, (pg/mL) | 9517.5 [4613.8–18367.7] | 5160.0 [2610.5–10032.9] | 5861.0 [2593.8–8693.8] | 0.013 |
| CK-MB, (mmol/L) | 35.0 [15.5–74.9] | 16.0 [9.5–24.1] | 19.0 [15.5–29.6] | 0.003 |
| CTnI, (mmol/L) | 2.0 [0.96–5.24] | 0.74 [0.22–3.99] | 0.22 [0.05–8.79] | 0.134 |
| LDH, (U/L) | 737.0 [399.0–1229.0] | 604.0 [361.0–745.0] | 460.5 [288.8–915.5] | 0.248 |
| AST, (mmol/L) | 84.0 [33.5–328.5] | 37.0 [21.0–58.5] | 31.0 [20.0–278.0] | 0.191 |
| Hemoglobin, (g/L) | 121.4 ± 15.8 | 129.1 ± 47.3 | 126.3 ± 19.8 | 0.413 |
| WBC, (103/μL) | 13.0 ± 6.43 | 10.9 ± 6.18 | 11.8 ± 4.26 | 0.277 |
| Creatinine, (μmol/L) | 101.5 [74.7–159.2] | 88.4 [78.5–100.4] | 94.7 [78.3–137.5] | 0.328 |
| Blood urea nitrogen, (mmol/L) | 12.2 ± 8.74 | 9.40 ± 4.58 | 12.0 ± 8.19 | 0.252 |
| eGFR, (mL/min/1.73 m2) | 73.6 ± 34.2 | 68.5 ± 18.9 | 61.8 ± 27.2 | 0.208 |
| Total bilirubin, (mmol/L) | 20.6 ± 16.8 | 16.4 ± 9.45 | 21.3 ± 18.0 | 0.426 |
| Albumin, (mmol/L) | 36.9 ± 9.75 | 37.1 ± 7.74 | 37.5 ± 6.82 | 0.965 |
| LDL-C, (mmol/L) | 2.25 ± 0.74 | 2.35 ± 0.96 | 2.32 ± 0.80 | 0.857 |
| 30-day mortality, n (%) | 73 (93.6) | 7 (22.6) | 2 (11.1) | <0.001 |
| Long-term mortality, n (%) | 75 (96.2) | 8 (25.8) | 4 (22.2) | <0.001 |
| Survival time (days) | 5.0 [2.0–12.0] | 892.0 [45.0–1698.0] | 1059.0 [529.75–1323.25] | <0.001 |
VSR, ventricular septal rupture; TCC, Percutaneous transcatheter closure;
VSR Type: Acute (Within 24 hours Post AMI), Subacute (Within 24–72 h Post AMI), Late presentation (More than 72 h Post AMI); SD, Standard Deviation; AMI, acute myocardial infarction; IABP, intra-aortic balloon pump; ECMO, extracorporeal membrane oxygenation; STEMI, ST segment elevate myocardial infarction; CAG, coronary angiography; LAD, left anterior descending; RCA, right coronary artery; LCX, left circumflex coronary artery; PCI, percutaneous coronary intervention; CABG, coronary artery bypass surgery; TIA, transient ischemic attack; SBP, systolic blood pressure; DBP, diastolic blood pressure; LVEF, left ventricular eject fraction; NT-pro BNP, N-terminal pro b-type natriuretic peptide; CK-MB, creatine kinase MB; CTNI, cardiac troponin I; LDH, lactate dehydrogenase; WBC, white blood cell; eGFR, estimated glomerular filtration rate; AST, aspartate transaminase; LDL-C, low-density lipoprotein cholesterol. P values in bold meant significantly different (P < 0.05).