New risk factors for early- and late-onset cardiac rupture in ST-elevation myocardial infarction patients after primary percutaneous coronary intervention

•This case-control study documents new risk factors strongly related with cardiac rupture (CR) after primary percutaneous coronary intervention.•Acute hyperglycemia and thrombocytopenia are strongly associated with early and late CR, respectively.•Emergent surgical repair may lead to a reduction of in-hospital mortality in CR patients.•Early prediction of CR using clinical risk factors may improve mortality in ST-elevation myocardial infarction patients. Cardiac rupture (CR) is a catastrophic complication of acute myocardial infarction. Primary percutaneous coronary intervention (pPCI) reduces the incidence of CR. This study aimed to investigate the clinical risk factors and characteristics of CR after pPCI. This was a retrospective, case-control, multicenter study. We enrolled 2444 consecutive patients with ST-elevation myocardial infarction (STEMI) who had undergone pPCI between 2009 and 2015; 33 patients experienced CR (1.35%): 19 were assigned as early CR (≤72 h) and 14 as late CR (>72 h). The 132 controls were randomly selected from the 2411 STEMI patients without CR, by matching institutions at a 1:4 ratio. : Multivariate logistic regression revealed that female sex, acute hyperglycemia, thrombocytopenia (platelets