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Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era

Background: 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. Methods: Data were collected from the DIAMANTE registry that incl...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381467/
https://www.ncbi.nlm.nih.gov/pubmed/37510949
http://dx.doi.org/10.3390/jcm12144834
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author 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
author_facet 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
author_sort Velásquez-Rodríguez, Jesús
collection PubMed
description Background: 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. Methods: 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. Results: 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%, p < 0.001); however, in multivariate analysis, HAVB was not an independent predictor of in-hospital mortality. Conclusions: 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.
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spelling pubmed-103814672023-07-29 Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era 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 J Clin Med Article Background: 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. Methods: 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. Results: 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%, p < 0.001); however, in multivariate analysis, HAVB was not an independent predictor of in-hospital mortality. Conclusions: 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. MDPI 2023-07-22 /pmc/articles/PMC10381467/ /pubmed/37510949 http://dx.doi.org/10.3390/jcm12144834 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/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/).
spellingShingle Article
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
Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era
title Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era
title_full Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era
title_fullStr Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era
title_full_unstemmed Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era
title_short Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era
title_sort prognostic implications of high-degree atrio-ventricular block in patients with acute myocardial infarction in the contemporary era
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381467/
https://www.ncbi.nlm.nih.gov/pubmed/37510949
http://dx.doi.org/10.3390/jcm12144834
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