Frequency of left ventricular free-wall rupture in patients with acute myocardial infarction treated with primary angioplasty

The main advantage of primary percutaneous transluminal coronary angioplast y (PTCA) over thrombolytic therapy for the treatment of acute myocardial in farction (AMI) is the achievement of a higher rate of coronary patency with a lower risk of intracranial bleeding, which includes lower mortality and a reduction of the reinfarction rate, especially in high-risk patients.(1,2 ) Free-wall rupture (FWR) constitutes the second most common cause of in-ho spital death in patients with AMI, ranging from 0.8% to 6%.(3-5) It has bee n suggested and even widely accepted that primary PTCA reduces the risk of FWR, especially when a successful result is achieved.(6-9) However, the ris k of FWR in patients with AMI treated with primary angioplasty has not been studied in detail. This study was conducted to assess the incidence of FWR in patients with AMI treated with primary angioplasty, as well as to inves tigate the clinical and angiographic variables associated with a higher ris k of FWR in this setting.