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November 12, 2020Clinical CardiologyOpen Access

Clinical impact of complete atrioventricular block in patients with ST‐segment elevation myocardial infarction

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Key result

Complete AV block in anterior STEMI predicts ~82% mortality and MACCE, unlike nonanterior infarcts.

  • P<0.05
  • n=1,295

Why the study?

Although complete atrioventricular block had higher mortality in the thrombolytic era, little was known about its clinical impact on STEMI patients undergoing primary PCI.

Does complete atrioventricular block increase the risk of all-cause death and MACCE in STEMI patients undergoing primary PCI?

Population

1295 STEMI patients undergoing primary PCI within 24 hours from onset

Comparison

Patients with CAVB vs without CAVB, stratified by anterior vs nonanterior STEMI

Design

Consecutive observational cohort study

Follow-up

Median 3.8 (1.7-6.6) years

Authors

YKYosuke KawamuraHYHiroaki YokoyamaKKKazutaka Kitayama

Discussion

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Member takes

Overview

CAVB signals high mortality risk in anterior STEMI; leaves open whether targeted interventions improve outcomes.

Study Design

Type

Cohort (n=1,295)

Structured PICO

Does complete atrioventricular block increase the risk of all-cause death and MACCE in STEMI patients undergoing primary PCI?

P
Population
1295 STEMI patients undergoing primary PCI within 24 hours from onset (640 anterior STEMI, 655 nonanterior STEMI)
I
Intervention
Development of complete atrioventricular block (CAVB)
C
Comparator
No complete atrioventricular block
O
Outcome
All-cause death and major adverse cardiocerebrovascular events (MACCE) at a median follow-up of 3.8 yearshard clinical

Main Result

p-value: p=<0.05

Complete atrioventricular block remains a poor prognostic complication in anterior STEMI patients undergoing primary PCI, independently predicting all-cause mortality and MACCE.

Cite This Study

Kawamura et al. (2020) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=1,295). Complete atrioventricular block (CAVB) vs. No CAVB was evaluated on All-cause death and major adverse cardiocerebrovascular events (MACCE) (p=<0.05). Complete atrioventricular block in anterior STEMI patients independently predicted all-cause mortality (82% vs 20%, p<0.05) and MACCE (82% vs 25%, p<0.05), but not in nonanterior STEMI.

synapsesocial.com/papers/6a0e4deebc348c84f2fd99c4https://doi.org/10.1002/clc.23510
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1High-degree atrioventricular block complicating ST-segment elevation myocardial infarction in the era of primary percutaneous coronary intervention2012 · 140 citations
  2. 2The Conduction System in Acute Myocardial Infarction Complicated by Heart Block1968 · 141 citations
  3. 3Anatomy, histology, and pathology of the cardiac conduction system—part V1993 · 42 citations