The impact of the complete atrioventricular block on in-hospital and long-term mortality in patients treated with primary percutaneous coronary intervention
Background/Aim. The prognostic impact of complete atrioventricular (AV) block on the long-term prognosis of patients with ST-elevation myocardial infarction (STEMI) has not been fully determined. The aim of the study was to analyze the incidence and prognostic impact of complete AV block on in-hospi...
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| Format: | Article |
| Language: | English |
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Military Health Department, Ministry of Defance, Serbia
2023-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502200004S.pdf |
| _version_ | 1811155184861052928 |
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| author | Savić Lidija Mrdović Igor Ašanin Milika Stanković Sanja Krljanac Gordana |
| author_facet | Savić Lidija Mrdović Igor Ašanin Milika Stanković Sanja Krljanac Gordana |
| author_sort | Savić Lidija |
| collection | DOAJ |
| description | Background/Aim. The prognostic impact of complete atrioventricular (AV) block on the long-term prognosis of patients with ST-elevation myocardial infarction (STEMI) has not been fully determined. The aim of the study was to analyze the incidence and prognostic impact of complete AV block on in-hospital mortality (IHM) and 6-year mortality in STEMI patients treated with primary percutaneous coronary intervention. Methods. The study included 3,044 consecutive STEMI patients. Results. Complete AV block was registered only on admission in 144 (4.73%) patients; 125 (86.8%) patients with complete AV block had inferior infarction. A temporary pacemaker was implanted in 72 (50%) patients with complete AV block. No patient under-went permanent pacemaker implantation. IHM was significantly higher in patients with complete AV block than in patients without complete A V b lock: 1 7.9% v s. 3 .6%, respectively, p < 0.001. In patients with heart block and inferior infarction, IHM was 13%, whereas IHM was 53% in patients with heart block and anterior infarction. When we analyzed patients discharged alive from the hospital, we also found a significantly higher long-term (6-year) mortality rate in those with complete AV block vs. patients without AV block: 7.8% vs. 3.4%, respectively, p < 0.001. Complete AV block was an independent predictor for IHM and 6-year mortality: IHM [odds ratio (OR) 2.94 95%, confidence interval (CI) 1.23–5.22; 6-year mortality hazard ratio (HR) 1.61, 95%, CI 1.10–2.37]. When subanalysis was performed in patients with inferior STEMI, complete AV block was an independent predictor of IHM and 6 -year mortality, while in patients with anterior STEMI, complete AV block was an independent predictor of IHM. Conclusion. In analyzed STEMI patients, complete AV block was transitory and was registered only on hospital admission. Although transitory, complete AV block remained a strong independent predictor of IHM and long-term mortality. |
| first_indexed | 2024-04-10T04:29:58Z |
| format | Article |
| id | doaj.art-d42dee964fca4a0a842fa86bd212770c |
| institution | Directory Open Access Journal |
| issn | 0042-8450 2406-0720 |
| language | English |
| last_indexed | 2024-04-10T04:29:58Z |
| publishDate | 2023-01-01 |
| publisher | Military Health Department, Ministry of Defance, Serbia |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj.art-d42dee964fca4a0a842fa86bd212770c2023-03-10T08:07:55ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502406-07202023-01-01801162210.2298/VSP210926004S0042-84502200004SThe impact of the complete atrioventricular block on in-hospital and long-term mortality in patients treated with primary percutaneous coronary interventionSavić Lidija0Mrdović Igor1Ašanin Milika2Stanković Sanja3https://orcid.org/0000-0003-1865-5761Krljanac Gordana4https://orcid.org/0000-0002-4849-7031University Clinical Center of Serbia, Emergency Hospital, Cardiology Clinic, Coronary Care Unit, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaUniversity Clinical Center of Serbia, Emergency Hospital, Cardiology Clinic, Coronary Care Unit, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaUniversity Clinical Center of Serbia, Emergency Hospital, Cardiology Clinic, Coronary Care Unit, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaUniversity of Belgrade, Faculty of Medicine, Belgrade, Serbia + University Clinical Center of Serbia, Emergency Hospital, Cardiology Clinic, Center for Medical Biochemistry, Belgrade, SerbiaUniversity Clinical Center of Serbia, Emergency Hospital, Cardiology Clinic, Coronary Care Unit, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaBackground/Aim. The prognostic impact of complete atrioventricular (AV) block on the long-term prognosis of patients with ST-elevation myocardial infarction (STEMI) has not been fully determined. The aim of the study was to analyze the incidence and prognostic impact of complete AV block on in-hospital mortality (IHM) and 6-year mortality in STEMI patients treated with primary percutaneous coronary intervention. Methods. The study included 3,044 consecutive STEMI patients. Results. Complete AV block was registered only on admission in 144 (4.73%) patients; 125 (86.8%) patients with complete AV block had inferior infarction. A temporary pacemaker was implanted in 72 (50%) patients with complete AV block. No patient under-went permanent pacemaker implantation. IHM was significantly higher in patients with complete AV block than in patients without complete A V b lock: 1 7.9% v s. 3 .6%, respectively, p < 0.001. In patients with heart block and inferior infarction, IHM was 13%, whereas IHM was 53% in patients with heart block and anterior infarction. When we analyzed patients discharged alive from the hospital, we also found a significantly higher long-term (6-year) mortality rate in those with complete AV block vs. patients without AV block: 7.8% vs. 3.4%, respectively, p < 0.001. Complete AV block was an independent predictor for IHM and 6-year mortality: IHM [odds ratio (OR) 2.94 95%, confidence interval (CI) 1.23–5.22; 6-year mortality hazard ratio (HR) 1.61, 95%, CI 1.10–2.37]. When subanalysis was performed in patients with inferior STEMI, complete AV block was an independent predictor of IHM and 6 -year mortality, while in patients with anterior STEMI, complete AV block was an independent predictor of IHM. Conclusion. In analyzed STEMI patients, complete AV block was transitory and was registered only on hospital admission. Although transitory, complete AV block remained a strong independent predictor of IHM and long-term mortality.http://www.doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502200004S.pdfatrioventricular blockmortalitypercutaneous coronary interventionprognosisst elevation myocardial infarction |
| spellingShingle | Savić Lidija Mrdović Igor Ašanin Milika Stanković Sanja Krljanac Gordana The impact of the complete atrioventricular block on in-hospital and long-term mortality in patients treated with primary percutaneous coronary intervention Vojnosanitetski Pregled atrioventricular block mortality percutaneous coronary intervention prognosis st elevation myocardial infarction |
| title | The impact of the complete atrioventricular block on in-hospital and long-term mortality in patients treated with primary percutaneous coronary intervention |
| title_full | The impact of the complete atrioventricular block on in-hospital and long-term mortality in patients treated with primary percutaneous coronary intervention |
| title_fullStr | The impact of the complete atrioventricular block on in-hospital and long-term mortality in patients treated with primary percutaneous coronary intervention |
| title_full_unstemmed | The impact of the complete atrioventricular block on in-hospital and long-term mortality in patients treated with primary percutaneous coronary intervention |
| title_short | The impact of the complete atrioventricular block on in-hospital and long-term mortality in patients treated with primary percutaneous coronary intervention |
| title_sort | impact of the complete atrioventricular block on in hospital and long term mortality in patients treated with primary percutaneous coronary intervention |
| topic | atrioventricular block mortality percutaneous coronary intervention prognosis st elevation myocardial infarction |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502200004S.pdf |
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