Risk factors and predictive model for mortality in acute myocardial infarction with ventricular septal rupture at high altitudes

doi:10.4330/wjc.v17.i7.109044

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 17, Issue 7

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (194)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-4) series, Tables (1-6) series.

Item

Count

PDF

HTML

Figures (1-4)

Tables (1-6)

Sum=154

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

Download

Sum=31

Jul 26, 2025 (publication date) through Jul 25, 2025

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Cardiology

ISSN

1949-8462

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Cardiol. Jul 26, 2025; 17(7): 109044
Published online Jul 26, 2025. doi: 10.4330/wjc.v17.i7.109044

Table 1 Comparison of baseline data between groups, n (%)

Baseline data	Survival group (n = 30)	Death group (n = 18)	χ²/t	P value
Gender	17 (56.7)	11 (61.1)	0.091	0.762
Age (years) (mean ± SD)	65.1 ± 6.7	71 ± 11.2	2.303	0.026
BMI (kg/m²) (mean ± SD)	23.8 ± 3.6	23.1 ± 3.0	-0.74	0.463
Smoking history	14 (46.7)	9 (50.0)	0.05	0.823
Drinking history	21 (70)	13 (72.2)	0.027	0.87
HTN	17 (56.7)	4 (22.2)	5.424	0.02
Hyperlipidemia	20 (66.7)	13 (72.2)	0.162	0.688
T2DM	19 (63.3)	11 (61.1)	0.024	0.878
Apoplexy	25 (83.3)	17 (94.4)	1.27	0.26
Angina pectoris	11 (36.7)	8 (44.4)	0.285	0.594
OMI	17 (56.7)	6 (33.3)	2.454	0.117
Liver dysfunction	9 (30.0)	13 (72.2)	8.078	0.004
SBP (mmHg) (mean ± SD)	105.3 ± 16.8	102.3 ± 21.4	-0.55	0.585
DBP (mmHg) (mean ± SD)	72.5 ± 13.1	72.6 ± 19.8	0.023	0.981
MBP (mmHg) (mean ± SD)	83.5 ± 12.0	79.1 ± 18.1	-0.995	0.325
HR (times/minute) (mean ± SD)	94.9 ± 20.2	102.1 ± 15.0	1.294	0.202
Acute extensive anterior MI	13 (43.3)	13 (72.2)	3.782	0.052
Early VSR	23 (76.7)	18 (100)	4.917	0.073
Killip ≥ III	19 (63.3)	15 (83.3)	2.178	0.14
Combined arrhythmia	9 (30.0)	5 (27.8)	0.027	0.87
Stent implantation	15 (50.0)	9 (50.0)	0	1
PaO₂/FiO₂ ≤ 200	3 (10.0)	1 (5.6)	0.291	1

BMI: Body mass index; HTN: Hypertension; T2DM: Type 2 diabetes; OMI: Old myocardial infarction; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; MBP: mean blood pressure; HR: Heart rate; MI: Myocardial infarction; VSR: Ventricular septal perforation.

Table 2 Comparison of laboratory indicators between groups (mean ± SD)

Laboratory index	Survival group	Death group	χ²/t	P value
hs-TnI (pg/mL)	1.1 ± 1.1	10.0 ± 13.0	2.889	0.010
NT-proBNP (pg/mL)	8789.3 ± 9310.2	16030.8 ± 12107.2	2.328	0.024
RBC (× 10⁹/L)	9.882 ± 3.9	14.2 ± 6.0	2.707	0.012
N% (%)	66.3 ± 25.8	81.4 ± 10.2	2.859	0.007
WBC (× 10¹²/L)	4.2 ± 0.7	3.8 ± 1.0	-1.948	0.057
Hb (g/L)	128.1 ± 18.9	115.3 ± 28.5	-1.878	0.067
PLT (× 10⁹/L)	59.4 ± 84.5	207.6 ± 1337.1	0.487	0.629
hs-CRP (mg/L)	57.7 ± 62.1	59.4 ± 53.0	0.095	0.925
ESR (mm/h)	33.1 ± 27.8	24.1 ± 21	-1.18	0.244
PCT (ng/mL)	0.8 ± 1.0	1.3 ± 1.7	1.175	0.251
IL-6 (pg/mL)	49.3 ± 33.5	110.7 ± 94.5	2.661	0.015
BUN (mmol/L)	12.8 ± 8.9	18.3 ± 11.2	1.891	0.065
UA (μmol/L)	505.4 ± 183.3	656.3 ± 308.3	1.886	0.071
eGFR [mL/(minute × 1.73 m²)]	47.0 ± 24.4	27.0 ± 14.6	-3.552	0.001
Glu (mmol/L)	9.5 ± 4.3	11.8 ± 5.8	1.395	0.174
HbA1c (%)	7.8 ± 1.9	8.0 ± 1.4	0.385	0.702
TC (mmol/L)	3.7 ± 0.9	3.4 ± 1.0	-0.787	0.435
LDL-C (mmol/L)	2.4 ± 0.6	2.2 ± 0.8	-1.071	0.290
TG (mmol/L)	1.6 ± 0.5	1.3 ± 0.5	-2.088	0.042
Lac (mmol/L)	1.7 ± 0.8	4.6 ± 4.5	2.728	0.014

hs-TnI: High-sensitivity cardiac troponin I; NT-proBNP: N-terminal pro-B-type natriuretic peptide precursor; RBC: Red blood cell count; N%: Neutrophil percentage; WBC: White blood cell count; Hb: Hemoglobin; PLT: Platelet count; hs-CRP: High-sensitivity C-reactive protein; ESR: Erythrocyte sedimentation rate; PCT: Procalcitonin; IL-6: Interleukin-6; BUN: Blood urea nitrogen; UA: Uric acid; eGFR: Estimated glomerular filtration rate; Glu: Glucose; HbA1c: Glycated hemoglobin; TC: Total cholesterol; LDL-C: Low-density lipoprotein cholesterol; TG: Triglycerideslactic acid; Lac: Lactic acid.

Table 3 Comparison of echocardiographic indexes between groups (mean ± SD), n (%)

Echocardiographic indicator	Survival group	Death group	χ²/t	P value
LAD (mm)	37.2 ± 5.0	37.2 ± 6.2	-0.007	0.995
LVEDD (mm)	50.7 ± 5.2	49.7 ± 7.5	-0.532	0.597
LVEF	47.1 ± 6.2	44.3 ± 7.2	-1.454	0.153
Ventricular aneurysm (mm)	24 (80.0)	13 (72.2)	0.385	0.790
Area of ventricular aneurysm (mm²)	11.8 ± 4.3	10.5 ± 4.3	-0.906	0.370
VSR is adjacent to the apex of the heart VSR	15 (50)	10 (55.6)	0.139	0.709
VSR size (mm)	15.1 ± 6.4	15.8 ± 5.5	0.382	0.704
Valve insufficiency	12 (40.0)	8 (44.4)	0.091	0.762
PAH	14 (46.7)	8 (44.4)	0.022	0.881
Pericardial effusion	9 (30.0)	5 (27.8)	0.027	0.870

LAD: Left atrial diameter; LVEDD: Left ventricular end-diastolic diameter; LVEF: Left ventricular ejection fraction; VSR: Ventricular septal rupture; PAH: Pulmonary arterial hypertension.

Table 4 Comparison of therapeutic indexes between groups, n (%)

Therapeutic index	Survival group	Death group	χ²/t	P value
Admitted vasoactive drugs	21 (70.0)	16 (88.9)	2.272	0.249
Antiarrhythmic drugs	12 (40.0)	4 (22.2)	1.6	0.206
IABP circulatory support	16 (53.3)	10 (55.6)	0.022	0.881
Ventilator-assisted ventilation	17 (56.7)	11 (61.1)	0.091	0.762
Stent implantation	15 (50.0)	9 (50.0)	0	1.000
Emergency myocardial reperfusion	17 (56.7)	9 (50.0)	0.201	0.654
30-day myocardial reperfusion	19 (63.3)	11 (61.1)	0.024	0.878
30-day septal repair	4 (13.3)	0 (0)	2.681	0.281
30-day septal closure	1 (3.3)	1 (5.6)	0.139	1.000

IABP: Intra-aortic balloon pump.

Table 5 Multivariate analysis of 30-day mortality in acute myocardial infarction complicated by ventricular septal rupture patients

Variable	Regression coefficient	Standard error	Wald χ²	P value	OR	95%CI
Age	0.137	0.055	6.255	0.012	1.147	1.03-1.278
UA	0.006	0.003	5.208	0.022	1.006	1.001-1.011
IL-6	0.034	0.015	5.279	0.022	1.034	1.005-1.064
Hb	-0.061	0.026	5.32	0.021	0.941	0.893-0.991

UA: Uric acid; IL-6: Interleukin-6; Hb: Hemoglobin; OR: Odds ratio; 95%CI: 95% confidence interval.

Table 6 Prediction value of age, uric acid, interleukin-6, and hemoglobin histogram prediction model

Predictive index	AUC	Optimum cutoff value	Sensitivity	Specificity	95%CI	P value
Age	0.663	0.471	0.500	0.883	0.499-0.827	0.061
UA	0.657	0.396	0.556	0.883	0.482-0.833	0.070
IL-6	0.744	0.570	0.611	1.000	0.582-0.907	0.005
Hb	0.632	0.373	0.611	0.667	0.463-0.802	0.128
Age + UA + IL-6 + Hb	0.939	0.432	0.889	0.867	0.875-1.000	< 0.001

UA: Uric acid; IL-6: Interleukin-6; Hb: Hemoglobin; AUC: Area under the receiver operating characteristic curve; OR: Odds ratio; 95%CI: 95% confidence interval.

Citation: Zhang LH, Cen ZF, Qiao Q, Ye XR, Cheng L, Liu GQ, Liu Y, Zhang XQ, Pan XF, Zhang HL, Zhang JJ. Risk factors and predictive model for mortality in acute myocardial infarction with ventricular septal rupture at high altitudes. World J Cardiol 2025; 17(7): 109044
URL: https://www.wjgnet.com/1949-8462/full/v17/i7/109044.htm
DOI: https://dx.doi.org/10.4330/wjc.v17.i7.109044