{
  "abstract": "Background: Mechanical complications (MCs) after acute myocardial infarction (AMI) are now uncommon but remain highly lethal, and contemporary data encompassing the full spectrum of rupture phenotypes are limited. Methods: We retrospectively identified all consecutive adults with post-AMI MCs managed at a tertiary regional referral center from 2015 to 2025. MCs included ventricular septal rupture (VSR), left ventricular free-wall rupture (LVFWR), contained rupture/pseudoaneurysm, and papillary muscle rupture (PMR). The primary endpoint was 30-day all-cause mortality. Exploratory analyses assessed treatment patterns by age, sex, geographical distance, and area-level income. Results: Among 59 patients (mean age 71.2 ± 10.7 years; 50.8% women), 17 (28.8%) had isolated VSR, 21 (35.6%) LVFWR, 10 (16.9%) combined VSR and contained LVFWR/pseudoaneurysm, and 11 (18.6%) PMR. Temporary mechanical circulatory support (MCS) and surgery were each used in 35 patients (59.3%). Thirty-day mortality was 59.3%. Among patients undergoing definitive invasive treatment, mortality was 45.7%. Older age was associated with higher 30-day mortality (OR per year 1.09, 95% CI 1.03–1.16), whereas surgery was associated with lower observed mortality (OR 0.22, 95% CI 0.07–0.73), acknowledging major treatment selection and survivor biases. Patients aged ≥75 years received MCS less frequently than younger patients (29.2% vs. 80.0%), and women underwent surgery less frequently than men (46.7% vs. 72.4%). Distance and area-level income were not associated with 30-day mortality. Conclusions: In a contemporary regional referral network, post-AMI MCs remained associated with extreme early mortality. Age and treatment selection were major determinants of observed outcomes, while marked age- and sex-related differences in treatment intensity warrant confirmation in larger multicenter cohorts.",
  "abstract_shown": true,
  "affiliations": [
    "Cardiology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain",
    "Instituto de Investigación del Principado de Asturias (ISPA), 33011 Oviedo, Spain",
    "Cardiology, Hospital de Sierrallana, 39300 Torrelavega, Spain",
    "Cardiology, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain",
    "Cardiac Surgery Critic Care Unit, Hospital Universitario Central de Asturias (HUCA), 33006 Oviedo, Spain",
    "Cardiac Surgery, Hospital Universitario Central de Asturias (HUCA), 33006 Oviedo, Spain",
    "Faculty of Medicine, University of Oviedo, 33006 Oviedo, Spain"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Alberto Alén",
      "orcid": "0000-0002-0771-4650"
    },
    {
      "affs": [
        0
      ],
      "name": "Andrés Álvarez-Gato",
      "orcid": "0009-0007-9255-4092"
    },
    {
      "affs": [
        0
      ],
      "name": "Manuel Sánchez"
    },
    {
      "affs": [
        2
      ],
      "name": "Francisco González-Urbistondo"
    },
    {
      "affs": [
        3
      ],
      "name": "María Salgado",
      "orcid": "0000-0001-6697-6274"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Rut Álvarez-Velasco",
      "orcid": "0000-0002-2837-7374"
    },
    {
      "affs": [
        4
      ],
      "name": "Miguel Ángel Rodríguez-Yago"
    },
    {
      "affs": [
        0
      ],
      "name": "María Isabel Soto"
    },
    {
      "affs": [
        1,
        5,
        6
      ],
      "name": "Jacobo Silva"
    },
    {
      "affs": [
        0,
        1,
        6
      ],
      "name": "Pablo Avanzas",
      "orcid": "0000-0002-4958-6108"
    },
    {
      "affs": [
        0,
        1,
        6
      ],
      "name": "Rebeca Lorca",
      "orcid": "0000-0002-7803-4011"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b8e48rwwpeyjr.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15207975",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706350/?tool=EBI",
  "id": "b8e48rwwpeyjr",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/7975",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Cardiac Structural Anomalies and Repair"
    ]
  ],
  "openalex": "W7222192466",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706350/pdf/?tool=EBI",
  "pmcid": "PMC13706350",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/b8e48rwwpeyjr.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15207975",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/7975"
    },
    {
      "first_seen": "2026-10-30T12:21:34Z",
      "native_id": "PMC:PMC13706350",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13706350"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Cardiac Structural Anomalies and Repair",
      "subfield": "surgery"
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  ],
  "title": "Mechanical Complications After Acute Myocardial Infarction: Contemporary Management, Treatment Selection, and Outcomes in a 10-Year Regional Referral Network",
  "title_text": "Mechanical Complications After Acute Myocardial Infarction: Contemporary Management, Treatment Selection, and Outcomes in a 10-Year Regional Referral Network",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:34Z",
  "url": "https://research.draconitic.com/paper/b8e48rwwpeyjr",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}