Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era
High-degree atrioventricular block (HAVB) is a known complication of ST-segment elevation myocardial infarction (STEMI). We aimed to determine the prevalence and prognostic impact of HAVB in a contemporary cohort of STEMI. Data were collected from the DIAMANTE registry that included STEMI patients a...
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| Veröffentlicht in: | Journal of clinical medicine 2023-07, Vol.12 (14), p.4834 |
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| creator | Velásquez-Rodríguez, Jesús Vicent, Lourdes Díez-Delhoyo, Felipe Valero Masa, María Jesús Bruña, Vanesa Sousa-Casasnovas, Iago Juárez-Fernández, Miriam Fernández-Avilés, Francisco Martínez-Sellés, Manuel |
| description | High-degree atrioventricular block (HAVB) is a known complication of ST-segment elevation myocardial infarction (STEMI). We aimed to determine the prevalence and prognostic impact of HAVB in a contemporary cohort of STEMI.
Data were collected from the DIAMANTE registry that included STEMI patients admitted to our cardiac intensive care unit treated with urgent reperfusion. We studied the clinical characteristics and evolution in patients with and without HAVB at admission.
From 1109 consecutive patients, HAVB was documented in 95 (8.6%). The right coronary artery was the culprit vessel in 84 patients with HAVB (88.4%). The independent predictors of HAVB were: male sex (OR 1.9, 95% CI 1.2-2.9), age (OR 1.03, 95% CI 1.01-1.05), involvement of right coronary artery (OR 12.4, 95% CI 7.6-20.2), and creatinine value (OR 1.5, 95% CI 1.1-2.0). A transient percutaneous pacemaker was used in 37 patients with HAVB (38.9%). Patients with HAVB had higher mortality that patients without HAVB (15.8% vs. 4.1%,
< 0.001); however, in multivariate analysis, HAVB was not an independent predictor of in-hospital mortality.
HAVB was seen in 9% of STEMI patients and was particularly frequent in elderly males with renal failure. Patients with HAVB had a poor prognosis during hospitalization, but HAVB was not an independent predictor of in-hospital mortality. |
| doi_str_mv | 10.3390/jcm12144834 |
| format | Article |
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Data were collected from the DIAMANTE registry that included STEMI patients admitted to our cardiac intensive care unit treated with urgent reperfusion. We studied the clinical characteristics and evolution in patients with and without HAVB at admission.
From 1109 consecutive patients, HAVB was documented in 95 (8.6%). The right coronary artery was the culprit vessel in 84 patients with HAVB (88.4%). The independent predictors of HAVB were: male sex (OR 1.9, 95% CI 1.2-2.9), age (OR 1.03, 95% CI 1.01-1.05), involvement of right coronary artery (OR 12.4, 95% CI 7.6-20.2), and creatinine value (OR 1.5, 95% CI 1.1-2.0). A transient percutaneous pacemaker was used in 37 patients with HAVB (38.9%). Patients with HAVB had higher mortality that patients without HAVB (15.8% vs. 4.1%,
< 0.001); however, in multivariate analysis, HAVB was not an independent predictor of in-hospital mortality.
HAVB was seen in 9% of STEMI patients and was particularly frequent in elderly males with renal failure. Patients with HAVB had a poor prognosis during hospitalization, but HAVB was not an independent predictor of in-hospital mortality.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm12144834</identifier><identifier>PMID: 37510949</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Analysis ; Angioplasty ; Cardiac arrhythmia ; Cardiovascular disease ; Clinical medicine ; Coronary vessels ; Creatinine ; Dosage and administration ; Heart attack ; Heart attacks ; Heart block ; Heart failure ; Hospitalization ; Medical imaging ; Medical prognosis ; Mortality ; Pacemakers ; Physiology, Pathological ; Prevention ; Prognosis ; Regression analysis ; Risk factors ; Tenecteplase</subject><ispartof>Journal of clinical medicine, 2023-07, Vol.12 (14), p.4834</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-eec2b1f92ce5d355aa3dbb65eb109e7aaa123a1b85e3da49ad9e133bd87de87b3</citedby><cites>FETCH-LOGICAL-c477t-eec2b1f92ce5d355aa3dbb65eb109e7aaa123a1b85e3da49ad9e133bd87de87b3</cites><orcidid>0000-0003-3077-2856 ; 0000-0003-0289-6229 ; 0000-0001-7914-9788</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381467/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381467/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37510949$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Velásquez-Rodríguez, Jesús</creatorcontrib><creatorcontrib>Vicent, Lourdes</creatorcontrib><creatorcontrib>Díez-Delhoyo, Felipe</creatorcontrib><creatorcontrib>Valero Masa, María Jesús</creatorcontrib><creatorcontrib>Bruña, Vanesa</creatorcontrib><creatorcontrib>Sousa-Casasnovas, Iago</creatorcontrib><creatorcontrib>Juárez-Fernández, Miriam</creatorcontrib><creatorcontrib>Fernández-Avilés, Francisco</creatorcontrib><creatorcontrib>Martínez-Sellés, Manuel</creatorcontrib><title>Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>High-degree atrioventricular block (HAVB) is a known complication of ST-segment elevation myocardial infarction (STEMI). We aimed to determine the prevalence and prognostic impact of HAVB in a contemporary cohort of STEMI.
Data were collected from the DIAMANTE registry that included STEMI patients admitted to our cardiac intensive care unit treated with urgent reperfusion. We studied the clinical characteristics and evolution in patients with and without HAVB at admission.
From 1109 consecutive patients, HAVB was documented in 95 (8.6%). The right coronary artery was the culprit vessel in 84 patients with HAVB (88.4%). The independent predictors of HAVB were: male sex (OR 1.9, 95% CI 1.2-2.9), age (OR 1.03, 95% CI 1.01-1.05), involvement of right coronary artery (OR 12.4, 95% CI 7.6-20.2), and creatinine value (OR 1.5, 95% CI 1.1-2.0). A transient percutaneous pacemaker was used in 37 patients with HAVB (38.9%). Patients with HAVB had higher mortality that patients without HAVB (15.8% vs. 4.1%,
< 0.001); however, in multivariate analysis, HAVB was not an independent predictor of in-hospital mortality.
HAVB was seen in 9% of STEMI patients and was particularly frequent in elderly males with renal failure. Patients with HAVB had a poor prognosis during hospitalization, but HAVB was not an independent predictor of in-hospital mortality.</description><subject>Analysis</subject><subject>Angioplasty</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular disease</subject><subject>Clinical medicine</subject><subject>Coronary vessels</subject><subject>Creatinine</subject><subject>Dosage and administration</subject><subject>Heart attack</subject><subject>Heart attacks</subject><subject>Heart block</subject><subject>Heart failure</subject><subject>Hospitalization</subject><subject>Medical imaging</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>Pacemakers</subject><subject>Physiology, Pathological</subject><subject>Prevention</subject><subject>Prognosis</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Tenecteplase</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNptkkFv1DAQhSMEolXpiTuyxAUJpdixs3ZOaFlaulIregCu1sSZZL0k9tZOQD3zx-uopWwr7MNY42-e_UaTZa8ZPeG8oh-2ZmAFE0Jx8Sw7LKiUOeWKP987H2THMW5pWkqJgsmX2QGXJaOVqA6zP1fBd87H0RqyHna9NTBa7yLxLTm33Sb_jF1AJMsxWJ__QJeimXoI5FPvzU9iHblKFSkfyW87bsjSTCOSyxtvIDQWerJ2LQQzi87wuEGy8m7EYecDhBtyGuBV9qKFPuLxfTzKvp-dflud5xdfv6xXy4vcCCnHHNEUNWurwmDZ8LIE4E1dL0qskxeUAMAKDqxWJfIGRAVNhYzzulGyQSVrfpR9vNPdTfWAjZnNQK93wQ7pJ9qD1Y9vnN3ozv_SLLWRiYVMCu_uFYK_njCOerDRYN-DQz9FXSghqKp4VSb07RN066fgkr-Z4lQulGT_qA561Na1Pj1sZlG9lGXFSq7oIlEn_6HSbnCwxjtsbco_Knh_V2CCjzFg-2CSUT3Pjd6bm0S_2e_LA_t3Svgtub-_aQ</recordid><startdate>20230722</startdate><enddate>20230722</enddate><creator>Velásquez-Rodríguez, Jesús</creator><creator>Vicent, Lourdes</creator><creator>Díez-Delhoyo, Felipe</creator><creator>Valero Masa, María Jesús</creator><creator>Bruña, Vanesa</creator><creator>Sousa-Casasnovas, Iago</creator><creator>Juárez-Fernández, Miriam</creator><creator>Fernández-Avilés, Francisco</creator><creator>Martínez-Sellés, Manuel</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3077-2856</orcidid><orcidid>https://orcid.org/0000-0003-0289-6229</orcidid><orcidid>https://orcid.org/0000-0001-7914-9788</orcidid></search><sort><creationdate>20230722</creationdate><title>Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era</title><author>Velásquez-Rodríguez, Jesús ; 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We aimed to determine the prevalence and prognostic impact of HAVB in a contemporary cohort of STEMI.
Data were collected from the DIAMANTE registry that included STEMI patients admitted to our cardiac intensive care unit treated with urgent reperfusion. We studied the clinical characteristics and evolution in patients with and without HAVB at admission.
From 1109 consecutive patients, HAVB was documented in 95 (8.6%). The right coronary artery was the culprit vessel in 84 patients with HAVB (88.4%). The independent predictors of HAVB were: male sex (OR 1.9, 95% CI 1.2-2.9), age (OR 1.03, 95% CI 1.01-1.05), involvement of right coronary artery (OR 12.4, 95% CI 7.6-20.2), and creatinine value (OR 1.5, 95% CI 1.1-2.0). A transient percutaneous pacemaker was used in 37 patients with HAVB (38.9%). Patients with HAVB had higher mortality that patients without HAVB (15.8% vs. 4.1%,
< 0.001); however, in multivariate analysis, HAVB was not an independent predictor of in-hospital mortality.
HAVB was seen in 9% of STEMI patients and was particularly frequent in elderly males with renal failure. Patients with HAVB had a poor prognosis during hospitalization, but HAVB was not an independent predictor of in-hospital mortality.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>37510949</pmid><doi>10.3390/jcm12144834</doi><orcidid>https://orcid.org/0000-0003-3077-2856</orcidid><orcidid>https://orcid.org/0000-0003-0289-6229</orcidid><orcidid>https://orcid.org/0000-0001-7914-9788</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Angioplasty Cardiac arrhythmia Cardiovascular disease Clinical medicine Coronary vessels Creatinine Dosage and administration Heart attack Heart attacks Heart block Heart failure Hospitalization Medical imaging Medical prognosis Mortality Pacemakers Physiology, Pathological Prevention Prognosis Regression analysis Risk factors Tenecteplase |
| title | Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era |
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