scholarly journals The impact of complete atrioventricular block on in-hospital and long-term mortality in patients with ST-elevation myocardial infarction

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
L Savic ◽  
I Mrdovic ◽  
M Asanin ◽  
G Krljanac
Keyword(s):  
Heart Failure ◽  
Hospital Mortality ◽  
Heart Block ◽  
Independent Predictor ◽  
Av Block ◽  
St Elevation ◽  
Complete Atrioventricular ◽  
Complete Av Block ◽  
Long Term Mortality

Abstract Funding Acknowledgements Type of funding sources: None. Background/aim: Complete atrioventricular (AV) block is associated with worse in-hospital outcome in patients with ST-elevation myocardial infarction (STEMI), while whether it has an impact on long-term outcome is uncertain. The majority of previous studies that analyzed this issue are performed before introduction primary percutaneous coronary intervention (pPCI). The aim of this study was to analyse the incidence and the prognostic impact of complete AV block at admission on in-hospital and 6-year mortality in STEMI patients treated with pPCI. Method we analyzed 2863 consecutive STEMI patients without cardiogenic shock at admission. Clinical, laboratory and echocardiographic characteristics and prognosis were compared between patients with and without complete AV block at admission. Results Complete AV block at admission was registered in 134 (4.6%) patients; 117 (87.3%) patients with complete AV block had inferior infarction. In comparison without complete AV block, patients with complete AV block were older; they were more likely to have heart failure, lower blood pressure and lower creatinine clearance at admission, multi-vessel disease on initial coronary angiogram and lower pre-discharge left ventricular ejection fraction (EF). Temporary pacemaker was implanted in 68 (50%) patients with complete AV block. No patient underwent permanent pacemaker implantation. In-hospital mortality was significantly higher in patients with complete AV block than in patients without complete AV block: 17.9% vs 3.6%, respectively, p < 0.001. In patients with heart block and inferior infarction in-hospital mortality was 13%,  whereas in patients with heart block and anterior infarction in-hospital mortality was 53%. When we analyze patients who were discharged alive from the hospital, we also find significantly higher long-term (6-year) mortality rate in those with complete AV block at admission vs patients without AV block: 7.8% vs 3.4% respectively, p < 0.001 (Figure 1). The causes of death in patients with complete AV block during long-term follow up were cardiovascular, e.g. sudden death, reinfarction or worsening of heart failure. In Cox regression model complete AV block was an independent predictor for in-hospital and 6-year mortality: in-hospital mortality HR 2.54 85%CI 1.93-5.22, p = 0.011; six year mortality HR 1.61, 95CI 1,09-2.37, p = 0.017. Other independent predictors for both short- and long-term mortality were age, heart failure at admission, lower creatinine clearance at admission, EF and post-procedural flow TIMI <3 thorugh infarct-related artery. Conclusion Complete AV block at admission is an independent predictor for in-hospital and long-term mortality in STEMI patients treated with primary PCI. Abstract Figure 1

scholarly journals The impact of complete atrioventricular block on in-hospital and long-term mortality in patients treated with primary percutaneous coronary intervention

2022 ◽  
pp. 4-4
Author(s):  
Lidija Savic ◽  
Igor Mrdovic ◽  
Milika Asanin ◽  
Sanja Stankovic ◽  
Gordana Krljanac
Keyword(s):  
Hospital Mortality ◽  
Heart Block ◽  
Independent Predictor ◽  
Prognostic Impact ◽  
Inhospital Mortality ◽  
Av Block ◽  
The Impact ◽  
Complete Av Block ◽  
Long Term Mortality

Objective: To analyze the incidence and the prognostic impact of complete AV block on in-hospital and 6-year mortality in STEMI patients treated with pPCI. Method: Study included 3044 consecutive STEMI patients. Results: Complete AV block was registered only at admission in 144 (4.73%) patients; 125 (86.8%) patients with complete AV block had inferior infarction. Temporary pacemaker was implanted in 72 (50%) patients with complete AV block. No patient underwent permanent pacemaker implantation. In-hospital mortality was significantly higher in patients with complete AV block than in patients without complete AV block: 17.9%vs3.6%, respectively, p<0.001. In patients with heart block and inferior infarction inhospital mortality was 13%, whereas in patients with heart block and anterior infarction inhospital mortality was 53%. When we analyzed patients who were discharged alive from the hospital, we also found significantly higher long-term (6-year) mortality rate in those with complete AV block vs patients without AV block: 7.8%v 3.4% respectively, p<0.001. Complete AV block was an independent predictor for in-hospital and 6-year mortality: inhospital mortality OR 2.94 95%CI 1.23-5.22; six year mortality 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 in-hospital and 6-year mortality, while in patients with anterior STEMI, complete AV block was an independent predictor of in-hospital mortality. Conclusion: In analyzed STEMI patients complete AV block was transitory and was registered only at hospital admission. Although transitory, complete AV block remained a strong independent predictor of in-hospital and long-term mortality.

scholarly journals Triglyceride to high-density lipoprotein cholesterol ratio as a predictor of long-term mortality in patients with coronary artery disease after undergoing percutaneous coronary intervention: a retrospective cohort study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Xin-Ya Dai ◽  
Ying-Ying Zheng ◽  
Jun-Nan Tang ◽  
Xu-Ming Yang ◽  
Qian-Qian Guo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Independent Predictor ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Cholesterol Ratio ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Lower Group ◽  
Long Term Mortality

Abstract Background It has been confirmed that the triglyceride to high-density lipoprotein cholesterol ratio (THR) is associated with insulin resistance and metabolic syndrome. However, to the best of our knowledge, only a few studies with small sample sizes have investigated the relationship between THR and coronary artery disease (CAD). Therefore, we aimed to assess the correlation between the THR and long-term mortality in patients with CAD after undergoing percutaneous coronary intervention (PCI) in our study that enrolled a large number of patients. Methods A total of 3269 post-PCI patients with CAD were enrolled in the CORFCHD-ZZ study from January 2013 to December 2017. The mean follow-up time was 37.59 ± 22.24 months. Patients were divided into two groups according to their THR value: the lower group (THR < 2.84, n = 1232) and the higher group (THR ≥ 2.84, n = 2037). The primary endpoint was long-term mortality, including all-cause mortality (ACM) and cardiac mortality (CM). The secondary endpoints were major adverse cardiac events (MACEs) and major adverse cardiac and cerebrovascular events (MACCEs). Results In our study, ACM occurred in 124 patients: 30 (2.4%) in the lower group and 94 (4.6%) in the higher group (P = 0.002). MACEs occurred in 362 patients: 111 (9.0%) in the lower group and 251 (12.3%) in the higher group (P = 0.003). The number of MACCEs was 482: 152 (12.3%) in the lower group and 320 (15.7%) in the higher group (P = 0.008). Heart failure occurred in 514 patients: 89 (7.2%) in the lower group and 425 (20.9%) in the higher group (P < 0.001). Kaplan–Meier analyses showed that elevated THR was significantly related to long-term ACM (log-rank, P = 0.044) and the occurrence of heart failure (log-rank, P < 0.001). Multivariate Cox regression analyses showed that the THR was an independent predictor of long-term ACM (adjusted HR = 2.042 [1.264–3.300], P = 0.004) and heart failure (adjusted HR = 1.700 [1.347–2.147], P < 0.001). Conclusions An increased THR is an independent predictor of long-term ACM and heart failure in post-PCI patients with CAD.

Elevated C-reactive protein in acute coronary syndrome presentation is an independent predictor of long-term mortality and heart failure

2007 ◽  
Vol 40 (5-6) ◽  
pp. 326-329 ◽  
Author(s):  
Peter A. Kavsak ◽  
Andrew R. MacRae ◽  
Alice M. Newman ◽  
Viliam Lustig ◽  
Glenn E. Palomaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Independent Predictor ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Long Term Mortality

scholarly journals In-hospital and long-term mortality in patients with arrhythmic storm

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
D Garcia-Arribas ◽  
E Lopez De Sa ◽  
S Rosillo ◽  
J Caro ◽  
E Armada ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Cause Of Death ◽  
First Episode ◽  
Term Survival ◽  
Long Term Mortality

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Beca para la Formación e Investigación en Cuidados Críticos Cardiológicos concedida por la Asociación de Cardiopatía Isquémica y Cuidados Críticos Cardiológicosde la SEC Introduction Available data on arrhythmic storm (AS) is usually obtained from retrospective observational studies based on series of patients (pts) with ICD or who undergo ablation. Therefore, selection bias limits the evidence regarding mortality and prognosis of this entity. Purpose/ Methods Describe in-hospital and long-term mortality of pts admitted between 2006 and 2020 for AS in the Acute Cardiac Care Unit (ACCU) of 2 tertiary hospitals in Spain. Results A total of 190 episodes of AS in 169 pts were retrospectively analysed. Baseline characteristics are depicted in Table 1. In-hospital mortality was 18.9%. Mortality in STEMI related AS was 44.2%, while in the rest of aetiologies was 6.1% (p &lt; 0.001). In-hospital cause of death was heart failure or cardiogenic shock (32.4%), refractory AS (20.6%), cardiac arrest due to pulseless activity (8.8%), severe postanoxic encephalopathy (14.7%), septic shock (8.8%), others (14.7%). long-term follow-up was obtained in 154 pts. Among those patients who survived after the first episode of AS, median follow up was 2.85 years. Long term mortality was 49.7%. Long-term survival did not differ among STEMI related AS (8.30 years, 95% CI 5.62 to 10.98) and the rest of aetiologies (6.91 years, 95% CI 5.75 to 8.07), Log rank 0.33. Kapplan-Meier survival curves are presented in Figure 1. Long-term cause of death was AS (8.3%), heart failure or cardiogenic shock (14.6%), cardiac arrest due to pulseless activity (4.2%), STEMI (2.1%), stroke (8.3%), cancer (10.4%), pneumonia and sepsis (22.9%) and unknown (29.2%). Conclusion In-hospital mortality in patients with AS requiring admission to an ACCU differs depending on the aetiology being worst in STEMI related AS. Long term mortality remains high and do not depend on the ethiology. Baseline CharacteristicsAge (SD) years66.5 (13.3)Male gender (%)141 (83.4)Previous VT ablation38 (22.4)Previous LVEF (SD)37.9 (13.1)Previous coronary artery disease (%)77 (45.5)Hypertrophic myocardiopathy (%)4 (23.7)Dilated myocardiopathy (%)24 (14.2)Previous Myocarditis (%)1 (0.6)Ventricular dysplasia (%)2 (1.2)Canalopathy (%)3 (1.8)ICD carrier (%)95 (55.6)Abstract Figure 1

scholarly journals In Comparison to Pathological Q Waves, Selvester Score Is a Superior Diagnostic Indicator of Increased Long-Term Mortality Risk in ST Elevation Myocardial Infarction Patients Treated with Primary Coronary Intervention

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 799
Author(s):  
Maria Holicka ◽  
Pavla Cuckova ◽  
Katerina Hnatkova ◽  
Lumir Koc ◽  
Tomas Ondrus ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Independent Predictor ◽  
Total Mortality ◽  
Coronary Intervention ◽  
Laboratory Variables ◽  
St Elevation ◽  
Strong Independent Predictor ◽  
Long Term Mortality ◽  
Q Wave

The development of pathological Q waves has long been correlated with worsened outcome in patients with ST elevation myocardial infarction (STEMI). In this study, we investigated long-term mortality of STEMI patients treated by primary percutaneous coronary intervention (PPCI) and compared predictive values of Q waves and of Selvester score for infarct volume estimation. Data of 283 consecutive STEMI patients (103 females) treated by PPCI were analysed. The presence of pathological Q wave was evaluated in pre-discharge electrocardiograms (ECGs) recorded ≥72 h after the chest pain onset (72 h Q). The Selvester score was evaluated in acute ECGs (acute Selvester score) and in the pre-discharge ECGs (72 h Selvester score). The results were related to total mortality and to clinical and laboratory variables. A 72 h Q presence and 72 h Selvester score ≥6 was observed in 184 (65.02%) and 143 (50.53%) patients, respectively. During a follow-up of 5.69 ± 0.66 years, 36 (12.7%) patients died. Multivariably, 72 h Selvester score ≥6 was a strong independent predictor of death, while a predictive value of the 72 h Q wave was absent. In high-risk subpopulations defined by clinical and laboratory variables, the differences in total mortality were highly significant (p < 0.01 for all subgroups) when stratified by 72 h Selvester score ≥6. On the contrary, the additional risk-prediction by 72 h Q presence was either absent or only borderline. In contemporarily treated STEMI patients, Selvester score is a strong independent predictor of long-term all-cause mortality. On the contrary, the prognostic value of Q-wave presence appears limited in contemporarily treated STEMI patients.

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