Open AccessThe impact of the complete atrioventricular block on in-hospital and long-term mortality in patients treated with primary percutaneous coronary intervention
Author(s) -
Lidija Savić,
Igor Mrdović,
Milika Ašanin,
Sanja Stanković,
Gordana Krljanać
Publication year - 2023
Publication title -
vojnosanitetski pregled
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.123
H-Index - 19
eISSN - 2406-0720
pISSN - 0042-8450
DOI - 10.2298/vsp210926004s
Subject(s) - medicine , atrioventricular block , myocardial infarction , cardiology , percutaneous coronary intervention , hazard ratio , heart block , confidence interval , odds ratio , heart failure , surgery , electrocardiography
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.