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Atrioventricular block in acute coronary syndrome patients
Session:
Posters - E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Speaker:
Hélder Santos
Congress:
CPC 2021
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Helder Santos; Mariana Santos; Ines Almeida; Hugo Miranda; Catarina sá; Joana Chin; Samuel Almeida; Catarina Sousa; Lurdes Almeida; on Behalf of The Portuguese Registry of Acute Coronary Syndromes
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif">Background: </span></span></strong><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif">The atrioventricular block (AVB) occurrence in acute</span></span><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"> coronary syndrome (ACS) is a potentially life-threatening complication, that demand a rapid and efficient response regarding reperfusion time and rhythm stabilization.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif">Objective:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"> Evaluate the impact and prognosis of AVB in ACS patients, as well as predictors of AVB.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif">Methods:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"> Multicenter retrospective study, based on the Portuguese Registry of ACS between 1/10/2010-3/05/2020. Patients were divided into two groups: A – patients without AVB, and B – patients that presented AVB. Were excluded patients without a previous cardiovascular history or clinical data regarding AVB occurrence. Logistic regression was performed to assess predictors of AVB in ACS patients.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif">Results:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"> From 32157 patients, 23774 was included, 23148 in group A (97.4%) and 626 in group B (2.6%). Both groups were similar regarding initial symptons until first medical contact (<em>p</em>=0.410), smoker status (<em>p</em>=0.222), arterial hypertension (<em>p</em>=0.776), diabetes mellitus (<em>p</em>=0.508), peripheral artery disease (<em>p</em>=0.479), chronic kidney disease (<em>p</em>=0.467) and re-infarction during the hospitalization for ACS (<em>p</em>=0.145). Group A had higher body mass index (27.4±4.4 vs 26.9±4.6, <em>p</em>=0.005), dislipidaemia (59.6 vs 51.4%, <em>p</em><0.001), coronary artery disease (18.9 vs 13.0, <em>p</em><0.001), heart rate (78±19 vs 65±25, <em>p</em><0.001), systolic blood pressure (139±29 vs 119±32, <em>p</em><0.001) and left ventricular ejection fraction (LVEF) >50% (60.1 vs 51.7%, <em>p</em><0.001). On the other hand, group B was elderly (66±13 vs 71±13, <em>p</em><0.001), female (27.4 vs 32.4%, p<0.001), previous stroke (6.9 vs 10.9%, p<0.001), neoplasia (4.9 vs 6.8%, p=0.031), ST-segment elevation myocardial infarction (46.2 vs 75.4%, p<0.001), syncope as major symptom (1.3 vs 10.0%, p<0.001), Killip-Kimball class > I (15.4 vs 31.6%, p<0.001), multivessel diasease (52.1 vs 61.4%, p<0.001), heart failure complication (15.5 vs 40.6%, p<0.001), cardiogenic shock complication (3.8 vs 24.6%, p<0.001), new-onset of atrial fibrillation (4.2 vs 14.1%, p<0.001), ACS mechanical complication (0.6 vs 3.2%, p<0.001), sustained ventricular tachycardia during ACS hospitalization (1.3 vs 10.0%, p<0.001), cardiac arrest (2.7 vs 13.3%, p<0.001), stroke complication (0.6 vs 1.9%, p<0.001) and hospitalization death (3.5 vs 19.0%, p<0.001). Logistic regression revealed that female gender (<em>odds ratio</em> (OR) 1.422, <em>p</em>=0.015, confidence interval (CI) 1.072-1.885), age ≥75 years old (OR 1.560, <em>p</em>=0.002, CI 1.174-2.073), heart rate <60 (OR 6.692, <em>p</em><0.001, CI 5.180-8.644) and Killip-Kimball class > I (OR 3.264, <em>p</em><0.001, CI 2.446-5.356) were predictors of AVB in ACS patients.</span></span></span></span></p> <p><strong><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif">Conclusions</span></span></strong><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif">: Female gender, age ≥75 years old, heart rate <60 and Killip-Kimball class > I were predictors of AVB in ACS patients.</span></span></p>
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