11 March 2002
Clinical implications of acute myocardial infarction complicated by high grade atrioventricular block.Francisco Ruiz-Ferrón, Mercedes Barranco-Ruiz, Humberto José Muńoz-Beltrán, Ziad Issa-Khozouz, Eduardo Aguayo de Hoyos, Manuel Ruiz-Bailén, Jesus Calatrava-López, Asuncion López-Martinez, Miguel Angel Díaz-Castellanos
Med Sci Monit 2002; 8(3): CR138-147 :: ID: 420913
BACKGROUND: The purpose of this study was to assess the incidence, clinicalcourse, prognosis and mean length of stay in acute myocardial infarction (AMI) complicated by high-gradeatrioventricular block (HAVB). MATERIAL/METHODS: A retrospective cohort study including all AMI patientslisted from January 1995 to September 2000 in the ARIAM multi-center register. Univariate analysis wascarried out to study the factors associated with the development of HAVB, the mortality rate, and themean length of stay, and multivariate logistic regression analysis to study whether HAVB is an independentpredictive variable for mortality or prolongation of stay. RESULTS: Of the 14,181 AMI patients includedin the register, 837 (5.9%) presented with HAVB, which was associated with age, female sex, increasedseverity, diabetes, inferior and Q-wave AMIs, and a higher peak creatine phosphokinase (CPK) level. TheHAVB patients developed more complications, required more diagnostic-therapeutic resources, and showedsignificantly higher mortality (p<0.0001) and increased mean length of stay (p<0.0001). The independent risk factors for HAVB were age, maximum peak CPK, inferior or combined localization of the AMI, Q-wave AMI, diabetes, a Killip and Kimball score > 1, and thrombolysis. HAVB was found to be an independent predictive variable for mortality and increased mean length of stay.
Conclusions: AMI patients with HAVB, despite thrombolytic treatment, are at risk for complications, mortality and longer mean admissions. Further study is needed on the outcome of a more active reperfusion policy, such as direct, rescue angioplasty etc.
Keywords: Heart Block, Logistic Models, Multivariate Analysis, Myocardial Infarction, Sex Factors, Time Factors
01 December 2021 : EditorialEditorial: SARS-CoV-2 Vaccine Responses and Breakthrough COVID-19
Med Sci Monit 2021; 27:e935624
03 December 2021 : Laboratory ResearchInfluenza and Influenza-Like Respiratory Virus Infections in Children During the 2019/20 Influenza Season a...
Med Sci Monit In Press; DOI: 10.12659/MSM.934862
08 November 2021 : Database AnalysisVirtual Screening and Molecular Docking to Study the Mechanism of Chinese Medicines in the Treatment of Cor...
Med Sci Monit In Press; DOI: 10.12659/MSM.934102
01 November 2021 : EditorialEditorial: What Can be Learned from National and International Vaccine Adverse Event Reporting Systems Duri...
Med Sci Monit 2022; 28:e935299
08 Dec 2021 : Review articleA Review of Emerging Biomarkers for Immune Checkpoint Inhibitors in Tumors of the Gastrointestinal Tract
Med Sci Monit In Press; DOI: 10.12659/MSM.935348
07 Dec 2021 : Review articleA Review of the Impact of Neutrophils and Neutrophil Extracellular Traps (NETs) on the Development of Aorti...
Med Sci Monit In Press; DOI: 10.12659/MSM.935134
07 Dec 2021 : Review articleAdie’s Pupil: A Diagnostic Challenge for the Physician
Med Sci Monit In Press; DOI: 10.12659/MSM.934657
Most Viewed Current Articles
20 Mar 2020 : Clinical ResearchSocial Capital and Sleep Quality in Individuals Who Self-Isolated for 14 Days During the Coronavirus Diseas...
Med Sci Monit 2020; 26:e923921
15 Apr 2020 : Clinical ResearchPsychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 20...
Med Sci Monit 2020; 26:e924171
05 May 2020 : Review articleAn Evidence Based Perspective on mRNA-SARS-CoV-2 Vaccine Development
Med Sci Monit 2020; 26:e924700