Incidence, predictors, and outcome of significant atrioventricular block in acute coronary syndrome − A study from major center in North-Eastern India

Background: Indian studies on significant atrioventricular (AV) block in entire spectrum of acute coronary syndrome (ACS) and its relation with clinical outcome are limited. Aims: The aim of this study is to determine the incidence, clinical predictor, and outcome of significant AV block complicatin...

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Main Authors: Bornali Dutta, Farhin Iqbal, Waseem Farooqui
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Journal of Clinical and Preventive Cardiology
Subjects:
Online Access:http://www.jcpconline.org/article.asp?issn=2250-3528;year=2022;volume=11;issue=1;spage=15;epage=21;aulast=Dutta
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author Bornali Dutta
Farhin Iqbal
Waseem Farooqui
author_facet Bornali Dutta
Farhin Iqbal
Waseem Farooqui
author_sort Bornali Dutta
collection DOAJ
description Background: Indian studies on significant atrioventricular (AV) block in entire spectrum of acute coronary syndrome (ACS) and its relation with clinical outcome are limited. Aims: The aim of this study is to determine the incidence, clinical predictor, and outcome of significant AV block complicating entire spectrum of ACS. Methods: All patients presenting with ACS from June 2017 to December 2018 were included in the study. The study population was divided into case and control groups based on the presence of significant AV block, either at admission or during hospitalization. The baseline clinical characteristics, mode of presentation, clinical course in the hospital, treatments in hospital, and complications related to the ACS and its treatment were analyzed between case and control groups. The inhospital and 30 day outcome was also analyzed. Results: A total of 1001 patients with ACS were included. One hundred and twenty-five patients of ACS with significant AV block comprised the study population (cases) and the rest 876 patients with ACS without significant AV block comprised the control population. The overall incidence of significant AV block was 12.48%. Patients with significant AV block had higher incidence of diabetes (40% vs. 20.77%, P-0.001), hypertension (36.8% vs. 20.89%, P-0.002), and history of smoking (57.6% vs. 34.2%, P-0.0001). On clinical presentation, patients with significant AV block had lower mean heart rate and higher killip class. Inferior wall myocardial infarction (44.4% vs. 22.8%, P-0.0001) was higher in cases, whereas anterior wall myocardial infarction (25.6% vs. 43.3% P-0.001) and unstable angina (4% vs. 10.2%, P-0.02) were higher in controls. Percentage of patients undergoing temporary pacemaker implantation or percutaneous coronary intervention during hospitalization was higher in cases. At 30 days, mortality was significantly higher among cases (24% vs. 8.1%, P-0.0001). Conclusion: Our data represent the first reported study on significant AV block in entire spectrum of ACS in North-eastern India and has noted the high incidence of significant AV block in our population and is associated with a worse short-term outcome.
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spelling doaj.art-cd87a0881ff341e39951ca232df42cc52022-12-22T02:20:12ZengWolters Kluwer Medknow PublicationsJournal of Clinical and Preventive Cardiology2250-35282022-01-01111152110.4103/jcpc.jcpc_12_21Incidence, predictors, and outcome of significant atrioventricular block in acute coronary syndrome − A study from major center in North-Eastern IndiaBornali DuttaFarhin IqbalWaseem FarooquiBackground: Indian studies on significant atrioventricular (AV) block in entire spectrum of acute coronary syndrome (ACS) and its relation with clinical outcome are limited. Aims: The aim of this study is to determine the incidence, clinical predictor, and outcome of significant AV block complicating entire spectrum of ACS. Methods: All patients presenting with ACS from June 2017 to December 2018 were included in the study. The study population was divided into case and control groups based on the presence of significant AV block, either at admission or during hospitalization. The baseline clinical characteristics, mode of presentation, clinical course in the hospital, treatments in hospital, and complications related to the ACS and its treatment were analyzed between case and control groups. The inhospital and 30 day outcome was also analyzed. Results: A total of 1001 patients with ACS were included. One hundred and twenty-five patients of ACS with significant AV block comprised the study population (cases) and the rest 876 patients with ACS without significant AV block comprised the control population. The overall incidence of significant AV block was 12.48%. Patients with significant AV block had higher incidence of diabetes (40% vs. 20.77%, P-0.001), hypertension (36.8% vs. 20.89%, P-0.002), and history of smoking (57.6% vs. 34.2%, P-0.0001). On clinical presentation, patients with significant AV block had lower mean heart rate and higher killip class. Inferior wall myocardial infarction (44.4% vs. 22.8%, P-0.0001) was higher in cases, whereas anterior wall myocardial infarction (25.6% vs. 43.3% P-0.001) and unstable angina (4% vs. 10.2%, P-0.02) were higher in controls. Percentage of patients undergoing temporary pacemaker implantation or percutaneous coronary intervention during hospitalization was higher in cases. At 30 days, mortality was significantly higher among cases (24% vs. 8.1%, P-0.0001). Conclusion: Our data represent the first reported study on significant AV block in entire spectrum of ACS in North-eastern India and has noted the high incidence of significant AV block in our population and is associated with a worse short-term outcome.http://www.jcpconline.org/article.asp?issn=2250-3528;year=2022;volume=11;issue=1;spage=15;epage=21;aulast=Duttaacute coronary syndromeatrioventricular blocknorth-eastern india
spellingShingle Bornali Dutta
Farhin Iqbal
Waseem Farooqui
Incidence, predictors, and outcome of significant atrioventricular block in acute coronary syndrome − A study from major center in North-Eastern India
Journal of Clinical and Preventive Cardiology
acute coronary syndrome
atrioventricular block
north-eastern india
title Incidence, predictors, and outcome of significant atrioventricular block in acute coronary syndrome − A study from major center in North-Eastern India
title_full Incidence, predictors, and outcome of significant atrioventricular block in acute coronary syndrome − A study from major center in North-Eastern India
title_fullStr Incidence, predictors, and outcome of significant atrioventricular block in acute coronary syndrome − A study from major center in North-Eastern India
title_full_unstemmed Incidence, predictors, and outcome of significant atrioventricular block in acute coronary syndrome − A study from major center in North-Eastern India
title_short Incidence, predictors, and outcome of significant atrioventricular block in acute coronary syndrome − A study from major center in North-Eastern India
title_sort incidence predictors and outcome of significant atrioventricular block in acute coronary syndrome a study from major center in north eastern india
topic acute coronary syndrome
atrioventricular block
north-eastern india
url http://www.jcpconline.org/article.asp?issn=2250-3528;year=2022;volume=11;issue=1;spage=15;epage=21;aulast=Dutta
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AT farhiniqbal incidencepredictorsandoutcomeofsignificantatrioventricularblockinacutecoronarysyndromeastudyfrommajorcenterinnortheasternindia
AT waseemfarooqui incidencepredictorsandoutcomeofsignificantatrioventricularblockinacutecoronarysyndromeastudyfrommajorcenterinnortheasternindia