Department of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Biomol Biomed. 2024 Sep 6;24(5):1077-1091. doi: 10.17305/bb.2024.10274.
Electrical storms (ESs) following percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) patients pose a significant challenge, affecting prognostic outcomes and increasing mortality. This meta-analysis synthesized data from 11 studies involving 9,666 AMI patients to identify risk factors associated with ES following PCI. Our findings revealed an average ES incidence of 7.70%, with identified risk factors including low thrombolysis in myocardial infarction (TIMI) flow grades (0-1), elevated cardiac troponin I levels, persistent hypotension, reperfusion arrhythmias, the right coronary artery being the infarct-related artery, increased diameter of the infarct-related artery, renal dysfunction, elevated creatine kinase-MB, and bradycardia. Notably, the use of β-blockers was found to significantly reduce the risk of ES. The study underscores the importance of early identification and management of these risk factors in AMI patients undergoing PCI to prevent the occurrence of ES, highlighting the protective role of β-blockers. This research provides a foundation for future strategies aimed at reducing the incidence and improving the prognosis of ES in this patient population.
急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后发生电风暴(ESs)是一个重大挑战,影响预后结局并增加死亡率。本荟萃分析综合了 11 项涉及 9666 例 AMI 患者的研究数据,以确定与 PCI 后 ES 相关的危险因素。我们的研究结果显示,ES 的平均发生率为 7.70%,确定的危险因素包括低心肌梗死溶栓治疗(TIMI)血流分级(0-1)、心肌肌钙蛋白 I 水平升高、持续低血压、再灌注心律失常、右冠状动脉为梗死相关动脉、梗死相关动脉直径增加、肾功能不全、肌酸激酶同工酶-MB 升高和心动过缓。值得注意的是,β受体阻滞剂的使用可显著降低 ES 的风险。该研究强调了在接受 PCI 的 AMI 患者中早期识别和管理这些危险因素的重要性,以预防 ES 的发生,并突出了β受体阻滞剂的保护作用。这项研究为旨在降低该患者人群 ES 发生率和改善预后的未来策略提供了基础。