Reperfusion arrhythmias after percutaneous coronary intervention: a benign process? Or malignant injury?
Journal Title: Chinese Journal of Clinical Research - Year 2024, Vol 37, Issue 9
Abstract
Objective To study the clinical characteristics and risk factors of reperfusion arrhythmia (RA) after emergency interventional treatment in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 791 patients diagnosed with acute STEMI and underwent percutaneous coronary intervention (PCI) at Xiangyang No.1 People's Hospital from January 2017 to January 2022 were selected as the study subjects. They were divided into the RA group (n=390) and the non-RA (NRA) group (n=401) based on whether RA occurred. The general and clinical data of the two groups were recorded, and the related factors of RA after PCI for acute STEMI were explored. Results There was no statistically significant difference between the two groups in terms of gender, age, history of hypertension, diabetes, smoking, hyperlipidemia, and atrial fibrillation (P>0.05). Compared with the NRA group, the systolic blood pressure, diastolic blood pressure, heart rate, and aspartate aminotransferase (AST) levels at admission were lower, while the left ventricular ejection fraction (LVEF) was higher in the RA group, with a statistically significant difference (P<0.05). Compared with the NRA group, the time from onset of pain to treatment was shorter in the RA group [(3.26±2.18) h vs (4.70±2.65) h, t=8.334, P<0.01], and the incidence of major adverse cardiovascular events (MACE) was lower in the RA group (3.1% vs 6.0%, χ2=3.849, P=0.049), with a statistically significant difference. There was a statistically significant difference in the location of myocardial infarction, infarct-related artery, and preoperative culprit vessel lesion between the two groups (P<0.05). Binary logistic analysis showed that ischemic time <6 h, severity of preoperative culprit vessel lesions, inferior wall infarction and right coronary artery infarction were all related factors for the occurrence of RA after PCI (P<0.05). Conclusion The occurrence of arrhythmia after PCI in STEMI patients is related to the reperfusion time, and PCI should be completed as soon as possible.
Authors and Affiliations
YANG Pan, LIU Fuyuan
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