Kosmidou I, et al. - This study entailed the examination of ST-segment elevation myocardial infarction (STEMI) patients treated with a primary percutaneous coronary intervention (PCI), in order to assess the incidence, predictors, and outcomes of worsened atrioventricular conduction (AVC) post-STEMI. It was observed that the progression of AVC system disease was uncommon in primary PCI patients. In addition, such progression occurred mainly in the setting of anterior myocardial infarction and, portended a high risk of death and major adverse cardiac events.

Methods

• Researchers undertook this current investigation including patients from the HORIZONS-AMI trial who underwent primary PCI and had available ECGs.
• They excluded patients with high-grade atrioventricular block or pacemaker implant at baseline.

Results

• Worsened AVC was indicated in 131 patients (worsened AVC group) and stable AVC in 2833 patients (stable AVC group) in ECGs analysis excluding the acute hospitalization period.
• Data reported that patients with worsened AVC were older, had a higher frequency of hypertension, diabetes, renal insufficiency, previous coronary artery bypass grafting, and predominant left anterior descending culprit lesions.
• Age, hypertension, and previous history of coronary artery disease were identified as predictors of worsened AVC.
• Researchers also observed an association of worsened AVC with an increased rate of all-cause death and major adverse cardiac events (death, myocardial infarction, ischemic target vessel revascularization, and stroke) as well as death or reinfarction at 3 years.
• On multivariable analysis, it was seen that worsened AVC remained an independent predictor of all-cause death (hazard ratio: 2.005, confidence interval: 1.051–3.827, P=0.0348) and major adverse cardiac events (hazard ratio 1.542, confidence interval: 1.059–2.244,P=0.0238).