Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan.
PLoS One. 2021 May 3;16(5):e0251124. doi: 10.1371/journal.pone.0251124. eCollection 2021.
High-degree atrioventricular block (HAVB) is a prognostic factor for survival in patients with inferior ST-segment elevation myocardial infarction (STEMI). However, there is little information about factors associated with temporary pacing (TP). The aim of this study was to find factors associated with TP in patients with inferior STEMI.
We included 232 inferior STEMI patients, and divided those into the TP group (n = 46) and the non-TP group (n = 186). Factors associated with TP were retrospectively investigated using multivariate logistic regression model.
The incidence of right ventricular (RV) infarction was significantly higher in the TP group (19.6%) than in the non-TP group (7.5%) (p = 0.024), but the incidence of in-hospital death was similar between the 2 groups (4.3% vs. 4.8%, p = 1.000). Long-term major adverse cardiovascular events (MACE), which were defined as a composite of all-cause death, non-fatal myocardial infarction (MI), target vessel revascularization (TVR) and readmission for heart failure, were not different between the 2 groups (p = 0.100). In the multivariate logistic regression analysis, statin at admission [odds ratio (OR) 0.230, 95% confidence interval (CI) 0.062-0.860, p = 0.029], HAVB at admission (OR 9.950, 95% CI 4.099-24.152, p<0.001), and TIMI-thrombus grade ≥3 (OR 10.762, 95% CI 1.385-83.635, p = 0.023) were significantly associated with TP.
Statin at admission, HAVB at admission, and TIMI-thrombus grade ≥3 were associated with TP in patients with inferior STEMI. Although the patients with TP had the higher incidence of RV infarction, the incidence of in-hospital death and long-term MACE was not different between patients with TP and those without.
高度房室传导阻滞（HAVB）是下壁 ST 段抬高型心肌梗死（STEMI）患者生存的预后因素。然而，关于临时起搏（TP）相关因素的信息较少。本研究旨在探讨下壁 STEMI 患者中与 TP 相关的因素。
我们纳入了 232 例下壁 STEMI 患者，并将其分为 TP 组（n = 46）和非 TP 组（n = 186）。使用多变量 logistic 回归模型回顾性调查与 TP 相关的因素。
TP 组（19.6%）右心室（RV）梗死的发生率明显高于非 TP 组（7.5%）（p = 0.024），但两组住院期间死亡率相似（4.3% vs. 4.8%，p = 1.000）。长期主要不良心血管事件（MACE）定义为全因死亡、非致死性心肌梗死（MI）、靶血管血运重建（TVR）和心力衰竭再入院的复合终点，两组之间无差异（p = 0.100）。多变量 logistic 回归分析显示，入院时使用他汀类药物（比值比[OR] 0.230，95%置信区间[CI] 0.062-0.860，p = 0.029）、入院时存在 HAVB（OR 9.950，95%CI 4.099-24.152，p<0.001）和血栓形成分级≥3（OR 10.762，95%CI 1.385-83.635，p = 0.023）与 TP 显著相关。
入院时使用他汀类药物、入院时存在 HAVB 和血栓形成分级≥3 与下壁 STEMI 患者的 TP 相关。尽管接受 TP 的患者 RV 梗死发生率较高，但 TP 患者与无 TP 患者的住院死亡率和长期 MACE 发生率无差异。
