High-grade atrioventricular block in acute coronary syndrome: Portuguese experience

Santos, H; Santos, Mariana; Almeida, Inês; Paula, Sofia B.; Chin, Joana; Almeida, S; Almeida, Lurdes

doi:10.1016/j.jelectrocard.2021.08.002

Cited by 5 publications

(11 citation statements)

References 17 publications

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“…We showed that a higher Killip class was associated with a higher risk of CAVB in STEMI patients treated with PCI. Although female gender was an independent predictor of the development of CAVB in previous studies [ 27 , 28 ], it was not significant in multivariate analysis in our study.…”

Section: Discussioncontrasting

confidence: 91%

“…Also, it was independently related to the development of CAVB. The Killip class was found to be a predictor of CAVB in acute coronary syndrome patients in a study published by Santos et al [ 28 ]. We showed that a higher Killip class was associated with a higher risk of CAVB in STEMI patients treated with PCI.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of CAVB was associated with in-hospital mortality in the acute coronary syndrome setting [ 29 ]. Different results have been reported in the related literature regarding the impact of CAVB on long-term mortality in the setting of ACS [ 26 – 28 ]. Kawamura et al showed that CAVB in nonanterior STEMI was associated with long-term mortality [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Kawamura et al showed that CAVB in nonanterior STEMI was associated with long-term mortality [ 29 ]. In another study, it was not an independent predictor of mortality in ACS patients [ 28 ]. CAVB patients had a higher rate of in-hospital mortality, however long-term mortality rate was not different between groups in the presented study.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between systemic immune inflammation index and development of complete atrioventricular block in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Esin,

Esen,

Aktürk

et al. 2024

BMC Cardiovasc Disord

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Background The systemic immune-inflammation index (SII), based on white blood cell, neutrophil, and platelet counts, is a proposed marker of systemic inflammation and immune activation. This study aimed to explore the relationship between SII and complete atrioventricular block (CAVB) development in STEMI patients undergoing primary PCI. Methods We retrospectively analyzed data from 883 patients who underwent primary PCI for STEMI between January 2009 and December 2017. Patients were categorized into two groups based on CAVB development. SII levels were calculated from blood samples taken on admission. Results Of the included patients, 48 (5.03%) developed CAVB. SII was higher in patients with CAVB compared to those without CAVB (1370 [1050–1779]x109/L vs. 771 [427–1462] x109/L, p < 0.001). Multivariate analysis showed a significant positive correlation between SII and the risk of CAVB development (OR:1.0003, 95%CI:1.0001–1.0005, P = 0.044). The cut-off value for the SII in the estimation of CAVB was 1117.7 × 109/L (area under the ROC curve [AUC]: 0.714, 95% CI = 0.657–0.770 with a sensitivity of 70.8% and specificity of 65.6%, p < 0.001). Conclusion This study showed a significant link between high SII levels and CAVB development in STEMI patients undergoing PCI. Our findings suggest that SII may be a valuable, routinely available, and inexpensive marker for identifying patients at increased risk of CAVB.

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Section: Discussioncontrasting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Relationship between systemic immune inflammation index and development of complete atrioventricular block in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Esin,

Esen,

Aktürk

et al. 2024

BMC Cardiovasc Disord

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“…Hemodynamic profile was often deteriorated due to TAVB and thus required timely recognition and treatment. 4…”

Section: Introductionmentioning

confidence: 99%

Reversible total atrioventricular block in a very high-risk non-ST-elevation myocardial infarction (NSTEMI) during conservative treatment in a limited resource setting: a case report

Susanti Mareta Anggraeni,

Ruth Grace Aurora

2024

InaJBCS

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Total atrioventricular (AV) block is the most common type of conduction disorder found in acute coronary syndrome (ACS), which requires timely recognition and treatment. This case report aimed to present conservative medical treatment for managing total AV block (TAVB) in a very high-risk non-ST-elevation myocardial infarction (NSTEMI) in a rural area. We reported a patient with TAVB in a very high-risk NSTEMI. The patient was hemodynamically unstable and needed immediate percutaneous coronary intervention (PCI). Due to limited facilities and difficult access to immediate PCI, the patient was treated conservatively with the NSTEMI protocol. Epinephrine, as a β-adrenergic agonist, was administered to improve hemodynamic status. During conservative treatment, TAVB was converted into the first-degree AV block on the third day of intensive care. In a setting where revascularization strategies and pacemaker implantation are not feasible, administration of antithrombotic agents and β-adrenergic agonists can be considered to manage TAVB with NSTEMI with close monitoring.

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

Velásquez‐Rodríguez

Vicent

Díez-Delhoyo

et al. 2023

JCM

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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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High-grade atrioventricular block in acute coronary syndrome: Portuguese experience

Cited by 5 publications

References 17 publications

Relationship between systemic immune inflammation index and development of complete atrioventricular block in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Relationship between systemic immune inflammation index and development of complete atrioventricular block in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Reversible total atrioventricular block in a very high-risk non-ST-elevation myocardial infarction (NSTEMI) during conservative treatment in a limited resource setting: a case report

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

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