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Complete Atrioventricular Block in Acute Coronary Syndrome: Prevalence, Characterisation and Implication on Outcome

2018-04Journal article Open access
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dc.contributor.authorAguiar Rosa, S
dc.contributor.authorTimóteo, AT
dc.contributor.authorFerreira, L
dc.contributor.authorCarvalho, R
dc.contributor.authorOliveira, MM
dc.contributor.authorCunha, PS
dc.contributor.authorViveiros Monteiro, A
dc.contributor.authorPortugal, G
dc.contributor.authorAlmeida Morais, L
dc.contributor.authorDaniel, P
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2019-10-22T15:23:05Z
dc.date.available2019-10-22T15:23:05Z
dc.date.issued2018-04
dc.description.abstractPURPOSE: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEur Heart J Acute Cardiovasc Care. 2018 Apr;7(3):218-223.pt_PT
dc.identifier.doi10.1177/2048872617716387pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3335
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSAGE Publicationspt_PT
dc.subjectAcute Coronary Syndromept_PT
dc.subjectAgedpt_PT
dc.subjectAtrioventricular Blockpt_PT
dc.subjectCardiac Pacing, Artificialpt_PT
dc.subjectCoronary Angiographypt_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectHumanspt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectPercutaneous Coronary Interventionpt_PT
dc.subjectPortugalpt_PT
dc.subjectPrevalencept_PT
dc.subjectPrognosispt_PT
dc.subjectProspective Studiespt_PT
dc.subjectSurvival Ratept_PT
dc.subjectElectrocardiographypt_PT
dc.subjectPropensity Scorept_PT
dc.subjectHSM CARpt_PT
dc.titleComplete Atrioventricular Block in Acute Coronary Syndrome: Prevalence, Characterisation and Implication on Outcomept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage223pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage218pt_PT
oaire.citation.titleEuropean Heart Journal: Acute Cardiovascular Carept_PT
oaire.citation.volume7pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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