{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:41:27Z","timestamp":1790419287960,"version":"4.1.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2010,11,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Hospital prognosis of moderate to severe pericardial effusion (MPE; \u226510 mm) in ST-elevation myocardial infarction is largely unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      Data from 446 ST-elevation myocardial infarction patients, 228 with MPE\u201488 with cardiac tamponade (CT) and electromechanical dissociation (EMD), 44 with CT without EMD (w\/oEMD), and 96 without initial CT\u2014and 218 with small PE (5 to 9 mm), were compared. Patients with MPE without initial CT were also compared with 96 patients without PE. CT patients showed larger PE (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) than those without initial CT; 85% of those with CT+EMD and 86% with CTw\/oEMD were treated with pericardiocentesis and 10% and 21% were treated with a surgical repair, respectively. Among MPE patients, 30-day mortality was 43% and was higher in those with CT+EMD (operated, 89%; and nonoperated, 85%) than in those with CTw\/oEMD (22% and 11%, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and those without initial CT (17%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). It was also higher than in patients with small PE (10%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) or those without PE (6%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.001). Death was attributable to cardiac rupture in 83% of patients with CT+EMD, 7% with CTw\/oEMD, and 8% with MPE without initial CT and occurred late (\u22657 days) in 14%, 67%, and 100%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>MPE carries an increased mortality that is highest in patients with CT+EMD. In those with CTw\/oEMD, however, mortality is considerably low after pericardiocentesis, and subsequent management may be individualized because a conservative approach is often successful. Importantly, MPE patients without initial CT are not free from late rupture and deserve further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.109.934968","type":"journal-article","created":{"date-parts":[[2010,10,26]],"date-time":"2010-10-26T00:58:55Z","timestamp":1288054735000},"page":"1902-1909","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":63,"title":["Hospital Outcome of Moderate to Severe Pericardial Effusion Complicating ST-Elevation Acute Myocardial Infarction"],"prefix":"10.1161","volume":"122","author":[{"given":"Jaume","family":"Figueras","sequence":"first","affiliation":[{"name":"From the Unitat Coron\u00e0ria, Servei de Cardiologia. Hospital Universitari Vall d'Hebron, Barcelona, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 A.","family":"Barrab\u00e9s","sequence":"additional","affiliation":[{"name":"From the Unitat Coron\u00e0ria, Servei de Cardiologia. Hospital Universitari Vall d'Hebron, Barcelona, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicens","family":"Serra","sequence":"additional","affiliation":[{"name":"From the Unitat Coron\u00e0ria, Servei de Cardiologia. Hospital Universitari Vall d'Hebron, Barcelona, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefa","family":"Cortadellas","sequence":"additional","affiliation":[{"name":"From the Unitat Coron\u00e0ria, Servei de Cardiologia. Hospital Universitari Vall d'Hebron, Barcelona, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa-Maria","family":"Lid\u00f3n","sequence":"additional","affiliation":[{"name":"From the Unitat Coron\u00e0ria, Servei de Cardiologia. Hospital Universitari Vall d'Hebron, Barcelona, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro","family":"Carrizo","sequence":"additional","affiliation":[{"name":"From the Unitat Coron\u00e0ria, Servei de Cardiologia. Hospital Universitari Vall d'Hebron, Barcelona, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Garcia-Dorado","sequence":"additional","affiliation":[{"name":"From the Unitat Coron\u00e0ria, Servei de Cardiologia. 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