The importance of GRACE risk score in the development of high-grade atrioventricular conduction blocks after non-st-segment elevation myocardial infarction
Küçük Resim Yok
Tarih
2023
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Verduci Publisher
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
OBJECTIVE: The development of high-grade atrioventricular block (HG-AVB) after acute coronary syndrome (ACS) increases morbidity and mortality rates. A significant por-tion of HG-AVBs resolve spontaneously after re-vascularization. We aimed to evaluate the pow-er of the GRACE scoring system in predicting the development of HG-AVB and its importance in determining the need for cardiac pacemakers. PATIENTS AND METHODS: Patients who ap-plied to our center between July 2020 and Feb-ruary 2023 were included in the study. 600 pa-tients [340 (56.6%) male, mean age 65.4 +/- 13.6] without ST-segment elevation (NSTEMI) and who underwent revascularization were evalu-ated within the scope of the study. The heart rhythms of the patients were evaluated from the electrocardiograms (ECG) at admission. Pa-tients with HG-AVB and other patients were di-vided into two groups. The heart rhythms of these patients were evaluated during their hos-pitalization. Then, HG-AVB patients were also divided into two groups (with and without PPM need). Demographic, laboratory, angiographic, and echocardiographic characteristics of these patients were evaluated. RESULTS: Morbidity and mortality were high-er in the HG-AVB group. These patients had lon-ger intensive care and hospital stays. The mean age, creatinine value, GRACE score (GS), to-tal cholesterol (TC), and RCA lesion rates were higher in the HG-AVB group; hemoglobin level was found to be lower. As a result of regression analysis, RCA lesion, hemoglobin value, GRACE score, creatinine, and TC levels were predic-tors of HG-AVB development. In determining the need for PPM, these variables were found to be effective. ROC analysis was performed for GS, which predicted the development of HG-AVB, and the cut-off value was found to be 185.5. CONCLUSIONS: The development of HG-AVB after NSTEMI is an important health problem. By detecting these patients and those who may need PPM beforehand, various complications can be prevented, and the length of stay in the hospital can be shortened. Calculation of GS is an important parameter that can be used to pre-dict the development and course of HG-AVB.
Açıklama
Anahtar Kelimeler
Non-ST segment elevation myocardial infarction, High-grade atrioventricular conduction block, GRACE risk score, Permanent pacemaker
Kaynak
European Review For Medical and Pharmacological Sciences
WoS Q Değeri
N/A
Scopus Q Değeri
Cilt
27
Sayı
20
