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Risk Factors of Periprocedural Bradycardia during Primary Percutaneous Coronary Intervention in Patients with Acute

Yong Li1, Shuzheng Lyu2

  • 1Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.

Cardiology Research and Practice
|December 13, 2019
PubMed

Insights

Periprocedural bradycardia during primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI) is linked to poor outcomes. Key risk factors include no-reflow, culprit vessel characteristics, and intraoperative hypotension.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Research

Background:

  • Periprocedural bradycardia can negate the benefits of primary percutaneous coronary intervention (PPCI).
  • This complication worsens prognosis in patients experiencing acute ST-elevation myocardial infarction (STEMI).

Purpose of the Study:

  • To identify and analyze risk factors associated with periprocedural bradycardia during PPCI.
  • Investigating predictors for bradycardia in acute STEMI patients undergoing PPCI.

Main Methods:

  • A cohort of 2,536 acute STEMI patients undergoing PPCI was analyzed.
  • Patients were categorized into bradycardia (434) and control (2102) groups based on intraoperative heart rate.
  • Demographic, clinical, and angiographic data were compared to identify risk factors.

Main Results:

  • The incidence of periprocedural bradycardia was 17.1%.
  • Logistic regression identified no-reflow, Left Anterior Descending (LAD) artery as culprit vessel, thrombus aspiration use, gender, complete culprit vessel blockage, and intraoperative hypotension as significant factors (P < 0.05).
  • The area under the ROC curve was 0.8390, indicating good predictive value.

Conclusions:

  • No-reflow, specific culprit vessel involvement (not LAD), use of thrombus aspiration devices, gender, complete vessel blockage, and intraoperative hypotension are potential independent risk factors for periprocedural bradycardia.
  • These findings aid in predicting and potentially mitigating bradycardia during PPCI in STEMI patients.
Abstract

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