Impact of Primary Percutaneous Coronary Intervention on Complete Atrioventricular Block With Acute Inferior ST-Elevation Myocardial Infarction

Malik, Jahanzeb; Laique, Talha; Farooq, Muhammad Hasan; Khan, Umar Hafiz; Malik, Farhan; Zahid, Muhammad; Majid, Atif

doi:10.7759/cureus.10013

Cited by 5 publications

(2 citation statements)

References 16 publications

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“…Несмотря на существенный прогресс высокотехнологических методов реваскуляризации миокарда, блокады сердца, ассоциированные с ИМ, являясь главным электрофизиологическим паттерном внезапной сердечной смерти, ухудшают ближайший и отдаленный прогноз. Успешная реперфузия, уменьшая степень и выраженность необратимых изменений в проводящей системе сердца, способствует восстановлению атриовентрикулярного проведения [8], и двукратно снижает риск внезапной сердечной смерти [9]. Тем не менее, по истечении времени вследствие хронической коронарной недостаточности и прогрессирования дегенеративных изменений в проводящей системе сердца блокады рецидивируют и требуют постоянной хронотропной поддержки, осуществляемой с помощью постоянной ЭКС.…”

Section: обсуждение полученных результатовunclassified

Predictors of pacemaker implantation in patients with myocardial infarction and heart block

Bryukhanova

Горбунова

Мамчур

2022

Vestnik aritmologii

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The aim of the study was to identify predictors of early and delayed pacemaker (PM) implantation in patients with myocardial infarction (MI) and heart block, allowing the development of models for predicting the feasibility of its implantation.Methods. A randomized selection method was used to form a cohort of patients with MI complicated by cardiac conduction disorders. The first (control) group included 72 patients who did not have a PM implanted, the second (n=46) and third (n=68) groups consisted of patients with MI, having, respectively, indications for early (in the acute period of MI) and delayed (average after 3 years) PM implantation. All patients underwent endovascular revascularization of the infarct-dependent artery during hospitalization. Demographic, clinical, and morphological predictors of PM implantation in patients of the second and third groups were evaluated in comparison with the control group. Multiple logistic regression was used to identify factors associated with the need for PM implantation in the short term (hospital period) and in the long-term period.Results. Factors that determine the expediency of a permanent PM in the acute period of MI at the hospital stage, delayed pacemaker implantation 3.2±1.9 years after myocardial infarction, as well as predictors that do not require a permanent PM throughout the entire observation period, were identified. The main factors that require permanent PM implantation in the acute period were identified: 3rd degree atrioventricular (AV) block in NSTEMI, GRACE score 96 or higher, development of 3rd degree AV block in MI of any localization except postero-inferior. Predictors for the need for PM implantation after 3.2±1.9 years (delayed period) were STEMI of anterior localization; at the same time, age had an inversely proportional relationship in predicting the fact of permanent pacing. The factors that determine the need for PM implantation are the presence of anterior MI, the multiple coronary artery lesions.Conclusion. In the acute (hospital) period of NSTEMI, PM implantation is indicated at a high risk of adverse cardiovascular complications (GRACE scale of 96 points and above), in the presence of the 3rd degree AV block in any MI localization, except for the inferior one. Indications for permanent pacing 3.2±1.9 years after an acute coronary event are STEMI of anterior localization and multiple coronary artery lesions.

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Section: обсуждение полученных результатовunclassified

Predictors of pacemaker implantation in patients with myocardial infarction and heart block

Bryukhanova

Горбунова

Мамчур

2022

Vestnik aritmologii

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“…Therefore, a thorough risk-benefit analysis is required for every patient. PCI continues to play key role in treating STEMI, and efforts to improve its accessibility and safety are crucial in the battle against cardiovascular disease 14 .…”

Section: Introductionmentioning

confidence: 99%

Develop a risk stratification model and clinical analysis to predict the impact of primary percutaneous coronary intervention on complete AV block in acute inferior STEMI patients

Khan¹,

Haq²,

Sahito

et al. 2023

ijhs

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Background: Acute inferior ST-elevation myocardial infarction (STEMI) is medical emergency entailing immediate intervention to restore blood flow and mitigate myocardial damage. Primary percutaneous coronary intervention (PCI) has replaced thrombolytic therapy as preferred treatment strategy for having superior outcomes. Objectives: To develop a risk stratification model incorporating the identified predictors to estimate the individual risk of complete AV block in patients undergoing primary PCI for acute inferior STEMI. Methods: This study enrolled 139 patients diagnosed with acute inferior STEMI who underwent primary PCI at the hospital. They were divided into two groups, i.e. pre-operative and post-operative carrying 54 and 85 patients, respectively. On admission, demographic, clinical data and peak values of cardiac biomarkers were obtained and the complications associated with PCI were elaborated. Results: Mean age of patients was 59.81+8.19 years, and comprised significantly more male (97) than female (42) patients (p<0.05). Proportion of patients with a history of complete AV block was 10.79%. Comorbidities included diabetes mellitus (33.09%), hypertension (49.64%), and dyslipidemia (64.74%).Coronary angiography findings for predicting AV block in patients with STEMI were categorized by location of culprit lesion in coronary vessels.

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Social determinants of pacemaker reuse among patients and family members in Pakistan

Mustafa¹,

Butt

Khan

et al. 2023

Expert Review of Cardiovascular Therapy

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Impact of Primary Percutaneous Coronary Intervention on Complete Atrioventricular Block With Acute Inferior ST-Elevation Myocardial Infarction

Cited by 5 publications

References 16 publications

Predictors of pacemaker implantation in patients with myocardial infarction and heart block

Predictors of pacemaker implantation in patients with myocardial infarction and heart block

Develop a risk stratification model and clinical analysis to predict the impact of primary percutaneous coronary intervention on complete AV block in acute inferior STEMI patients

Social determinants of pacemaker reuse among patients and family members in Pakistan

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