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直接经皮冠状动脉介入治疗对急性下壁ST段抬高型心肌梗死合并完全性房室传导阻滞的影响

Impact of Primary Percutaneous Coronary Intervention on Complete Atrioventricular Block With Acute Inferior ST-Elevation Myocardial Infarction.

作者信息

Malik Jahanzeb, Laique Talha, Farooq Muhammad Hasan, Khan Umar, Malik Farhan, Zahid Muhammad, Majid Atif

机构信息

Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, PAK.

Pharmacology, Lahore Medical and Dental College, Lahore, PAK.

出版信息

Cureus. 2020 Aug 25;12(8):e10013. doi: 10.7759/cureus.10013.

Abstract

Background and aims Complete atrioventricular block (CAVB) is associated with poor clinical outcomes in ST-elevation myocardial infarction (STEMI). This study determined the frequency and outcomes of primary percutaneous coronary intervention (PPCI) in patients with CAVB with acute inferior STEMI. Methods We conducted an observational, prospective study and enrolled 151 patients who were diagnosed with inferior STEMI. All patients received PPCI. The clinical outcomes were compared in patients with and without CAVB. The data was recorded on a collection form and analyzed on Statistical Package for Social Sciences (SPSS) software. Descriptive statistics were applied. For quantitative variables, standard deviation and mean were obtained, and statistical tests were also applied. Results Baseline characteristics were homogeneous in all patients. Half of the study population was either diabetic or hypertensive. Out of 151 participants, 21 (13.9%) developed CAVB. Two-thirds of the patients, who had developed heart block, reverted after PPCI. After a follow-up of two weeks, in-hospital mortality did not differ between the groups. Conclusion We conclude that PPCI can improve outcomes of CAVB-complicated acute inferior STEMI and suggest that primary PCI should be the preferred reperfusion therapy in patients with CAVB with STEMI.

摘要

背景与目的 完全性房室传导阻滞(CAVB)与ST段抬高型心肌梗死(STEMI)的不良临床结局相关。本研究确定了急性下壁STEMI合并CAVB患者接受直接经皮冠状动脉介入治疗(PPCI)的频率及结局。方法 我们进行了一项观察性前瞻性研究,纳入151例诊断为下壁STEMI的患者。所有患者均接受PPCI。对合并和未合并CAVB的患者的临床结局进行比较。数据记录在收集表上,并使用社会科学统计软件包(SPSS)进行分析。应用描述性统计。对于定量变量,获取标准差和均值,并进行统计检验。结果 所有患者的基线特征相似。研究人群中有一半患有糖尿病或高血压。在151名参与者中,21例(13.9%)发生了CAVB。发生心脏传导阻滞的患者中有三分之二在PPCI后恢复。随访两周后,两组的院内死亡率无差异。结论 我们得出结论,PPCI可改善合并CAVB的急性下壁STEMI的结局,并建议对于STEMI合并CAVB的患者,直接PCI应作为首选的再灌注治疗方法。

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