Complete Atrioventricular Block in Acute Coronary Syndrome: Prevalence, Characterisation and Implication on Outcome
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/3335 |
Resumo: | PURPOSE: The aim was to characterise acute coronary syndrome patients with complete atrioventricular block and to assess the effect on outcome. METHODS: Patients admitted with acute coronary syndrome were divided according to the presence of complete atrioventricular block: group 1, with complete atrioventricular block; group 2, without complete atrioventricular block. Clinical, electrocardiographic and echocardiographic characteristics and prognosis during one year follow-up were compared between the groups. RESULTS: Among 4799 acute coronary syndrome patients admitted during the study period, 91 (1.9%) presented with complete atrioventricular block. At presentation, group 1 patients presented with lower systolic blood pressure, higher Killip class and incidence of syncope. In group 1, 86.8% presented with ST-segment elevation myocardial infarction (STEMI), and inferior STEMI was verified in 79.1% of patients in group 1 compared with 21.9% in group 2 ( P<0.001). Right ventricular myocardial infarction was more frequent in group 1 (3.3% vs. 0.2%; P<0.001). Among patients who underwent fibrinolysis complete atrioventricular block was observed in 7.3% in contrast to 2.5% in patients submitted to primary percutaneous coronary intervention ( P<0.001). During hospitalisation group 1 had worse outcomes, with a higher incidence of cardiogenic shock (33.0% vs. 4.5%; P<0.001), ventricular arrhythmias (17.6% vs. 3.6%; P<0.001) and the need for invasive mechanical ventilation (25.3% vs. 5.1%; P<0.001). After a propensity score analysis, in a multivariate regression model, complete atrioventricular block was an independent predictor of hospital mortality (odds ratio 3.671; P=0.045). There was no significant difference in mortality at one-year follow-up between the study groups. CONCLUSION: Complete atrioventricular block conferred a worse outcome during hospitalisation, including a higher incidence of cardiogenic shock, ventricular arrhythmias and death. |
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Complete Atrioventricular Block in Acute Coronary Syndrome: Prevalence, Characterisation and Implication on OutcomeAcute Coronary SyndromeAgedAtrioventricular BlockCardiac Pacing, ArtificialCoronary AngiographyFollow-Up StudiesHumansMiddle AgedPercutaneous Coronary InterventionPortugalPrevalencePrognosisProspective StudiesSurvival RateElectrocardiographyPropensity ScoreHSM CARPURPOSE: The aim was to characterise acute coronary syndrome patients with complete atrioventricular block and to assess the effect on outcome. METHODS: Patients admitted with acute coronary syndrome were divided according to the presence of complete atrioventricular block: group 1, with complete atrioventricular block; group 2, without complete atrioventricular block. Clinical, electrocardiographic and echocardiographic characteristics and prognosis during one year follow-up were compared between the groups. RESULTS: Among 4799 acute coronary syndrome patients admitted during the study period, 91 (1.9%) presented with complete atrioventricular block. At presentation, group 1 patients presented with lower systolic blood pressure, higher Killip class and incidence of syncope. In group 1, 86.8% presented with ST-segment elevation myocardial infarction (STEMI), and inferior STEMI was verified in 79.1% of patients in group 1 compared with 21.9% in group 2 ( P<0.001). Right ventricular myocardial infarction was more frequent in group 1 (3.3% vs. 0.2%; P<0.001). Among patients who underwent fibrinolysis complete atrioventricular block was observed in 7.3% in contrast to 2.5% in patients submitted to primary percutaneous coronary intervention ( P<0.001). During hospitalisation group 1 had worse outcomes, with a higher incidence of cardiogenic shock (33.0% vs. 4.5%; P<0.001), ventricular arrhythmias (17.6% vs. 3.6%; P<0.001) and the need for invasive mechanical ventilation (25.3% vs. 5.1%; P<0.001). After a propensity score analysis, in a multivariate regression model, complete atrioventricular block was an independent predictor of hospital mortality (odds ratio 3.671; P=0.045). There was no significant difference in mortality at one-year follow-up between the study groups. CONCLUSION: Complete atrioventricular block conferred a worse outcome during hospitalisation, including a higher incidence of cardiogenic shock, ventricular arrhythmias and death.SAGE PublicationsRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEAguiar Rosa, STimóteo, ATFerreira, LCarvalho, ROliveira, MMCunha, PSViveiros Monteiro, APortugal, GAlmeida Morais, LDaniel, PCruz Ferreira, R2019-10-22T15:23:05Z2018-042018-04-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/3335engEur Heart J Acute Cardiovasc Care. 2018 Apr;7(3):218-223.10.1177/2048872617716387info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:42:27Zoai:repositorio.chlc.min-saude.pt:10400.17/3335Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:20:39.048915Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Complete Atrioventricular Block in Acute Coronary Syndrome: Prevalence, Characterisation and Implication on Outcome |
title |
Complete Atrioventricular Block in Acute Coronary Syndrome: Prevalence, Characterisation and Implication on Outcome |
spellingShingle |
Complete Atrioventricular Block in Acute Coronary Syndrome: Prevalence, Characterisation and Implication on Outcome Aguiar Rosa, S Acute Coronary Syndrome Aged Atrioventricular Block Cardiac Pacing, Artificial Coronary Angiography Follow-Up Studies Humans Middle Aged Percutaneous Coronary Intervention Portugal Prevalence Prognosis Prospective Studies Survival Rate Electrocardiography Propensity Score HSM CAR |
title_short |
Complete Atrioventricular Block in Acute Coronary Syndrome: Prevalence, Characterisation and Implication on Outcome |
title_full |
Complete Atrioventricular Block in Acute Coronary Syndrome: Prevalence, Characterisation and Implication on Outcome |
title_fullStr |
Complete Atrioventricular Block in Acute Coronary Syndrome: Prevalence, Characterisation and Implication on Outcome |
title_full_unstemmed |
Complete Atrioventricular Block in Acute Coronary Syndrome: Prevalence, Characterisation and Implication on Outcome |
title_sort |
Complete Atrioventricular Block in Acute Coronary Syndrome: Prevalence, Characterisation and Implication on Outcome |
author |
Aguiar Rosa, S |
author_facet |
Aguiar Rosa, S Timóteo, AT Ferreira, L Carvalho, R Oliveira, MM Cunha, PS Viveiros Monteiro, A Portugal, G Almeida Morais, L Daniel, P Cruz Ferreira, R |
author_role |
author |
author2 |
Timóteo, AT Ferreira, L Carvalho, R Oliveira, MM Cunha, PS Viveiros Monteiro, A Portugal, G Almeida Morais, L Daniel, P Cruz Ferreira, R |
author2_role |
author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Aguiar Rosa, S Timóteo, AT Ferreira, L Carvalho, R Oliveira, MM Cunha, PS Viveiros Monteiro, A Portugal, G Almeida Morais, L Daniel, P Cruz Ferreira, R |
dc.subject.por.fl_str_mv |
Acute Coronary Syndrome Aged Atrioventricular Block Cardiac Pacing, Artificial Coronary Angiography Follow-Up Studies Humans Middle Aged Percutaneous Coronary Intervention Portugal Prevalence Prognosis Prospective Studies Survival Rate Electrocardiography Propensity Score HSM CAR |
topic |
Acute Coronary Syndrome Aged Atrioventricular Block Cardiac Pacing, Artificial Coronary Angiography Follow-Up Studies Humans Middle Aged Percutaneous Coronary Intervention Portugal Prevalence Prognosis Prospective Studies Survival Rate Electrocardiography Propensity Score HSM CAR |
description |
PURPOSE: The aim was to characterise acute coronary syndrome patients with complete atrioventricular block and to assess the effect on outcome. METHODS: Patients admitted with acute coronary syndrome were divided according to the presence of complete atrioventricular block: group 1, with complete atrioventricular block; group 2, without complete atrioventricular block. Clinical, electrocardiographic and echocardiographic characteristics and prognosis during one year follow-up were compared between the groups. RESULTS: Among 4799 acute coronary syndrome patients admitted during the study period, 91 (1.9%) presented with complete atrioventricular block. At presentation, group 1 patients presented with lower systolic blood pressure, higher Killip class and incidence of syncope. In group 1, 86.8% presented with ST-segment elevation myocardial infarction (STEMI), and inferior STEMI was verified in 79.1% of patients in group 1 compared with 21.9% in group 2 ( P<0.001). Right ventricular myocardial infarction was more frequent in group 1 (3.3% vs. 0.2%; P<0.001). Among patients who underwent fibrinolysis complete atrioventricular block was observed in 7.3% in contrast to 2.5% in patients submitted to primary percutaneous coronary intervention ( P<0.001). During hospitalisation group 1 had worse outcomes, with a higher incidence of cardiogenic shock (33.0% vs. 4.5%; P<0.001), ventricular arrhythmias (17.6% vs. 3.6%; P<0.001) and the need for invasive mechanical ventilation (25.3% vs. 5.1%; P<0.001). After a propensity score analysis, in a multivariate regression model, complete atrioventricular block was an independent predictor of hospital mortality (odds ratio 3.671; P=0.045). There was no significant difference in mortality at one-year follow-up between the study groups. CONCLUSION: Complete atrioventricular block conferred a worse outcome during hospitalisation, including a higher incidence of cardiogenic shock, ventricular arrhythmias and death. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-04 2018-04-01T00:00:00Z 2019-10-22T15:23:05Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/3335 |
url |
http://hdl.handle.net/10400.17/3335 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Eur Heart J Acute Cardiovasc Care. 2018 Apr;7(3):218-223. 10.1177/2048872617716387 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
SAGE Publications |
publisher.none.fl_str_mv |
SAGE Publications |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799131302649135104 |