Giornale italiano di cardiologia : organo ufficiale della Federazione italiana di cardiologia : organo ufficiale della Società italiana di chirurgia cardiaca
-
G Ital Cardiol (Rome) · Jun 2008
[Death after ST-elevation myocardial infarction in patients treated with fibrinolytic therapy, angioplasty, or conventional therapy. A post-mortem study to verify cardiac rupture as a cause of death].
Experimental clinical observations suggest that fibrinolysis (FL) in acute myocardial infarction, even though reducing global mortality, is associated with an increasing incidence of death in the first 24-48 h. The responsible mechanism is not yet known, although available evidence supports heart rupture as the possible cause. ⋯ Our study shows that cardiac rupture is the major cause of death in patients with ST-elevation myocardial infarction treated with FL and PTCA, suggesting that mechanical and lythic reperfusion injury, in coagulative necrosis, may represent a further cause of cardiac rupture that occurs early or within the first hours.