High-degree atrioventricular block complicating ST segment elevation myocardial infarction in the contemporary era
| Autor: | Philippe Castellant, Philippe Druelles, Bertrand Avez, Gilles Rouault, Marielle Le Guellec, Jean-Claude Daubert, Dominique Boulmier, Raphaël P. Martins, Jean Philippe Hacot, Aurélie Loirat, Régis Delaunay, Martine Gilard, Hervé Le Breton, Emmanuelle Filippi, Guillaume Leurent, Isabelle Coudert, Josiane Treuil, Vincent Auffret, Marc Bedossa, Antoine Rialan, B. Boulanger |
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| Přispěvatelé: | Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [Vannes], Centre hospitalier de Vannes, Optimisation des régulations physiologiques (ORPHY (EA 4324)), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Service de cardiologie [Saint Malo], CH de Saint-Malo [Broussais], Service de cardiologie [Quimper], CH de Quimper, SAMU [Vannes], CHBA Vannes, SAMU [Brest], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Myocardial Infarction Myocardial Reperfusion Kaplan-Meier Estimate 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Reperfusion therapy Risk Factors Internal medicine Odds Ratio medicine Humans ST segment Hospital Mortality Registries 030212 general & internal medicine Myocardial infarction Atrioventricular Block Aged Proportional Hazards Models Retrospective Studies Aged 80 and over Chi-Square Distribution business.industry Incidence Cardiogenic shock Mortality rate Middle Aged medicine.disease 3. Good health Hospitalization Logistic Models Treatment Outcome Multivariate Analysis Cardiology Platelet aggregation inhibitor Myocardial infarction complications Female [SDV.IB]Life Sciences [q-bio]/Bioengineering France Myocardial infarction diagnosis Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors |
| Zdroj: | Heart Heart, BMJ Publishing Group, 2016, 102 (1), pp.40--49. ⟨10.1136/heartjnl-2015-308260⟩ Heart, 2016, 102 (1), pp.40--49. ⟨10.1136/heartjnl-2015-308260⟩ |
| ISSN: | 1355-6037 1468-201X |
| Popis: | International audience; Background High-degree atrioventricular block (HAVB) is a common complication of ST segment elevation myocardial infarction (STEMI). HAVB in STEMI is historically considered as a marker of worse outcome but overall data about HAVB in the contemporary era of mechanical reperfusion and potent antiplatelet therapies are scarce. Aim Analysing incidence, clinical correlates and impact on inhospital outcomes of HAVB in a large prospective registry (Observatoire Régional Breton sur l'Infarctus, ORBI) of modern management of STEMI with a special focus on potential differences between patients with HAVB on admission and those who developed HAVB during hospitalisation. Methods All patients enrolled in ORBI between June 2006 and December 2013 were included in the present analysis and were divided into 3 groups: patients without HAVB at any time, patients with HAVB on admission and those who developed HAVB during hospitalisation. Results A total of 6662 patients (age: 62.0 (52.0–74.0) years; male: 76.3%) were included in the present analysis. HAVB was documented in 3.5% of patients, present on admission in 63.7% of patients and occurring during hospitalisation in 36.3%. Patients with HAVB on admission or occurring during the first 24 h of hospitalisation had higher inhospital mortality rates (18.1% and 28.6%, respectively) than patients without (4.5%) or with HAVB occurring beyond the first 24 h of hospitalisation (8.0%). However by multivariable analysis, HAVB was not independently associated with inhospital mortality contrarily to age, presentation as cardiac arrest, anterior STEMI location, reperfusion therapy, cardiogenic shock, mechanical ventilation and occurrence of sustained ventricular tachyarrhythmias or mechanical complication. Conclusions Patients with HAVB had a higher mortality rate than patients without. However HAVB is not an independent predictor of inhospital mortality |
| Databáze: | OpenAIRE |
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