ArticleFrontiers in medicine2025
Risk factors for mechanical complications in very elderly patients with acute myocardial infarction.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The mortality rate for mechanical complications in very elderly acute myocardial infarction (AMI) patients is extremely high, but predictive tools specifically for this population are lacking. Methods: Mechanical complications (free-wall rupture, ventricular septal rupture, papillary muscle rupture/dysfunction, ventricular aneurysm) were independently validated. Differences in baseline characteristics, laboratory markers, and outcomes were compared. Missing data underwent sensitivity analysis, with >20% exclusion and <15% imputation. Regression modeling entered variables with univariate association ( Results: This retrospective cohort study analyzed 2,467 consecutive AMI patients aged ≥ 75 years. Mechanical complications occurred in 9.6% ( Conclusion: This study identifies ventricular aneurysm as the dominant mechanical complication in very elderly AMI patients, establishes a paradoxical protective role of hypertension history, and proposes a distinct risk profile integrating hemodynamic status, neutrophilic inflammation, and metabolic derangement. These findings are hypothesis-generating and highlight a potentially valuable stratification tool that warrants prospective validation in external cohorts before clinical application.
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