Temporal trends of atrioventricular block in acute coronary syndrome patients from the ACSIS registry

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart Rhythm O2 Pub Date : 2025-06-01 DOI:10.1016/j.hroo.2025.03.001

Shir Tal MD , Alon Barsheshet MD , Gal Sella MD , Yoni Kogan MD , Roy Beigel MD , Tal Ovdat , Gregory Golovchiner MD , Ran Kornowski MD , Katia Orvin MD

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Abstract

Background

High-degree atrioventricular block (HDAVB) is a life-threatening complication among acute coronary syndrome (ACS).

Objective

Our aim was to investigate temporal trends of the last two decades in incidence and prognosis of patients with HDAVB among patients who present with ACS.

Methods

We evaluated 18,717 ACS patients from the multicenter ACSIS (Acute Coronary Syndrome Israeli Survey) registry. Temporal trends were examined in early (2000–2010) and late (2013–2021) periods.

Results

Overall, HDAVB was diagnosed in 657 (3.5%) patients: 489 (4.25%) patients in the early period vs 168 (2.33%) in the late period (P < .001). Temporary pacemakers were implanted more frequently in the early vs the late period (59.4% vs 47%, P = .007), though implantation rate of permanent pacemakers was similar in both periods (11.3% vs 16.7%, P = .095). Patients with HDAVB from the late period experienced lower major adverse cardiovascular events (30.3% vs 43.8%, P = .003), 30-day mortality (18.9% vs 29.2%, P = .013) and 1-year mortality (26.1% vs 36.5%, P = .022). In multivariable analysis, admission Killip class >II (hazard ratio [HR] 2.85, P < .001), diabetes mellitus (HR 1.46, P = .01), and late period (vs early period, HR 1.44, P = .05) were independent predictors for 1-year mortality

Conclusion

ACS patients with HDAVB experience elevated short- and long-term mortality rates overall. However, there is improvement in outcomes for this population throughout the years.

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ACSIS登记的急性冠状动脉综合征患者房室传导阻滞的时间趋势

高程度房室传导阻滞（HDAVB）是急性冠脉综合征（ACS）中一种危及生命的并发症。目的：我们的目的是调查过去20年ACS患者中HDAVB的发病率和预后的时间趋势。方法：我们评估了来自多中心ACSIS（以色列急性冠脉综合征调查）登记处的18717例ACS患者。研究了早期（2000-2010年）和后期（2013-2021年）的时间趋势。结果657例（3.5%）患者确诊为HDAVB，早期489例（4.25%），晚期168例（2.33%）(P <；措施)。临时起搏器的植入频率在早期比晚期更高（59.4%比47%，P = 0.007），尽管永久性起搏器的植入率在两个时期相似（11.3%比16.7%,P = 0.095）。晚期HDAVB患者的主要不良心血管事件（30.3% vs 43.8%, P = 0.003）、30天死亡率（18.9% vs 29.2%, P = 0.013）和1年死亡率（26.1% vs 36.5%, P = 0.022）较低。在多变量分析中，入院Killip级>；II(风险比[HR] 2.85, P <；.001)、糖尿病（HR 1.46, P = 0.01）和晚期（相对于早期，HR 1.44, P = 0.05）是1年死亡率的独立预测因素。结论acs合并HDAVB患者总体上短期和长期死亡率升高。然而，这些年来，这一人群的预后有所改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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