Clinical impact of complete atrioventricular block in patients with ST-segment elevation myocardial infarction.
Aged
Atrioventricular Block
/ epidemiology
Cause of Death
/ trends
Female
Follow-Up Studies
Humans
Incidence
Japan
/ epidemiology
Male
Percutaneous Coronary Intervention
/ methods
Prognosis
Retrospective Studies
Risk Factors
ST Elevation Myocardial Infarction
/ complications
Survival Rate
/ trends
Time Factors
ST-segment elevation myocardial infarction
complete atrioventricular block
percutaneous coronary intervention
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
25
08
2020
revised:
25
10
2020
accepted:
02
11
2020
pubmed:
13
11
2020
medline:
18
8
2021
entrez:
12
11
2020
Statut:
ppublish
Résumé
Complete atrioventricular block (CAVB) is a common complication of ST-segment elevation myocardial infarction (STEMI). Although STEMI patients complicated with CAVB had a higher mortality in the thrombolytic era, little is known about the impact of CAVB on STEMI patients who underwent primary percutaneous coronary intervention (PCI). The study aimed at evaluating the clinical impact of CAVB on STEMI patients in the primary PCI era. We consecutively enrolled 1295 STEMI patients undergoing primary PCI within 24 hours from onset. Patients were divided into two groups according to the infarct location: anterior STEMI (n = 640) and nonanterior STEMI (n = 655). The outcomes were all-cause death and major adverse cardiocerebrovascular events (MACCE) with a median follow-up period of 3.8 (1.7-6.6) years. Eighty-one patients (6.3%) developed CAVB. The incidence of CAVB was lower in anterior STEMI patients than in nonanterior STEMI (1.7% vs 10.7%, p < .05). Anterior STEMI patients with CAVB had a higher incidence of all-cause deaths (82% vs 20%, p < .05) and MACCE (82% vs 25%, p < .05) than those without CAVB. Although higher incidence of all-cause deaths was found more in nonanterior STEMI patients with CAVB compared with those without CAVB (30% vs 18%, p < .05), there was no significant difference in the incidence of MACCE (24% vs 19%). Multivariate analysis showed that CAVB was an independent predictor for all-cause mortality and MACCE in anterior STEMI patients, but not in nonanterior STEMI. CAVB is rare in anterior STEMI patients, but remains a poor prognostic complication even in the primary PCI era.
Identifiants
pubmed: 33179796
doi: 10.1002/clc.23510
pmc: PMC7803372
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
91-99Informations de copyright
© 2020 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
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