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Effect of primary PCI on the recovery of atrioventricular block in inferior STEMI patients with late presentation (>12 hours): insights from a single center 10-year experience

There is no definite reperfusion time for inferior ST-elevation myocardial infarction (STEMI) patients presenting later than 12 hours after symptom onset and complicated by newly-developed atrioventricular block (AVB). It is not clear whether the percutaneous coronary intervention (PCI) could facili...

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Autores principales: Fan, Xiaojuan, Maharjan, Prabindra, Liu, Ping, Bai, Ling
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306870/
https://www.ncbi.nlm.nih.gov/pubmed/32217628
http://dx.doi.org/10.1136/jim-2019-001255
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author Fan, Xiaojuan
Maharjan, Prabindra
Liu, Ping
Bai, Ling
author_facet Fan, Xiaojuan
Maharjan, Prabindra
Liu, Ping
Bai, Ling
author_sort Fan, Xiaojuan
collection PubMed
description There is no definite reperfusion time for inferior ST-elevation myocardial infarction (STEMI) patients presenting later than 12 hours after symptom onset and complicated by newly-developed atrioventricular block (AVB). It is not clear whether the percutaneous coronary intervention (PCI) could facilitate the recovery of AVB in this patient group. We conducted a retrospective study including 52 consecutive inferior STEMI patients with presenting time >12 hours and new onset second or third-degree AVB on admission. All of them underwent PCI. The clinical characteristics, time to PCI and time to AVB improvement after symptom onset were studied. There were 42 males and the mean age was 61±10 years. Median presenting time from symptom onset was 36 hours (ranging 13–192 hours). Median time to PCI was 6.0 days (ranging 1–15 days) and median time of AVB improvement from symptom onset was 5.0 days (ranging 1–15 days). 24 patients got improvement of atrioventricular conduction before PCI procedure (defined as preoperative group) while 28 patients got improvement of atrioventricular conduction after PCI procedure (defined as postoperative group). In the postoperative group, there was a strong association between time to PCI and time to AVB improvement (R(2)=0.752, p=0.000). No adverse PCI procedure-related complications or death occurred and all the patients got complete AVB recovery at discharge. Early PCI is safe and should be recommended as the priority strategy for late presenting inferior STEMI patients when complicated by AVB. Successful reperfusion of the infarct-related artery is helpful to facilitate AVB recovery in this situation.
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spelling pubmed-73068702020-06-23 Effect of primary PCI on the recovery of atrioventricular block in inferior STEMI patients with late presentation (>12 hours): insights from a single center 10-year experience Fan, Xiaojuan Maharjan, Prabindra Liu, Ping Bai, Ling J Investig Med Brief Report There is no definite reperfusion time for inferior ST-elevation myocardial infarction (STEMI) patients presenting later than 12 hours after symptom onset and complicated by newly-developed atrioventricular block (AVB). It is not clear whether the percutaneous coronary intervention (PCI) could facilitate the recovery of AVB in this patient group. We conducted a retrospective study including 52 consecutive inferior STEMI patients with presenting time >12 hours and new onset second or third-degree AVB on admission. All of them underwent PCI. The clinical characteristics, time to PCI and time to AVB improvement after symptom onset were studied. There were 42 males and the mean age was 61±10 years. Median presenting time from symptom onset was 36 hours (ranging 13–192 hours). Median time to PCI was 6.0 days (ranging 1–15 days) and median time of AVB improvement from symptom onset was 5.0 days (ranging 1–15 days). 24 patients got improvement of atrioventricular conduction before PCI procedure (defined as preoperative group) while 28 patients got improvement of atrioventricular conduction after PCI procedure (defined as postoperative group). In the postoperative group, there was a strong association between time to PCI and time to AVB improvement (R(2)=0.752, p=0.000). No adverse PCI procedure-related complications or death occurred and all the patients got complete AVB recovery at discharge. Early PCI is safe and should be recommended as the priority strategy for late presenting inferior STEMI patients when complicated by AVB. Successful reperfusion of the infarct-related artery is helpful to facilitate AVB recovery in this situation. BMJ Publishing Group 2020-06 2020-03-25 /pmc/articles/PMC7306870/ /pubmed/32217628 http://dx.doi.org/10.1136/jim-2019-001255 Text en © American Federation for Medical Research 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, an indication of whether changes were made, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Brief Report
Fan, Xiaojuan
Maharjan, Prabindra
Liu, Ping
Bai, Ling
Effect of primary PCI on the recovery of atrioventricular block in inferior STEMI patients with late presentation (>12 hours): insights from a single center 10-year experience
title Effect of primary PCI on the recovery of atrioventricular block in inferior STEMI patients with late presentation (>12 hours): insights from a single center 10-year experience
title_full Effect of primary PCI on the recovery of atrioventricular block in inferior STEMI patients with late presentation (>12 hours): insights from a single center 10-year experience
title_fullStr Effect of primary PCI on the recovery of atrioventricular block in inferior STEMI patients with late presentation (>12 hours): insights from a single center 10-year experience
title_full_unstemmed Effect of primary PCI on the recovery of atrioventricular block in inferior STEMI patients with late presentation (>12 hours): insights from a single center 10-year experience
title_short Effect of primary PCI on the recovery of atrioventricular block in inferior STEMI patients with late presentation (>12 hours): insights from a single center 10-year experience
title_sort effect of primary pci on the recovery of atrioventricular block in inferior stemi patients with late presentation (>12 hours): insights from a single center 10-year experience
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306870/
https://www.ncbi.nlm.nih.gov/pubmed/32217628
http://dx.doi.org/10.1136/jim-2019-001255
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