Evaluation of hospital outcome of patients with STEMI with CHB who underwent pharmacological (thrombolytic) or PPCI reperfusion methods at Tabriz Shahid Madani Hospital in 2014-2018

Abstract

Introduction: Complete Heart block is one of the most important and fatal complications of acute STEMI.There are few studies comparing the clinical outcome of complete heart block in STEMI patients undergoing two different thrombolytic or angioplasty reperfusion procedures.In this study, we aimed to compare the clinical outcome of STEMI patients with complete heart block undergoing thrombolytic therapy or primary angioplasty. Methods: In this retrospective study, 127 patients who underwent reperfusion with thrombolytic or primary angioplasty after acute myocardial infarction with complete heart block in 1390-97 were enrolled in the study.Baseline clinical, laboratory, and angiographic findings as well as hospital outcome were compared in these two groups. Results: 80 patients in the primary angioplasty group and 47 patients in the thrombolytic therapy group developed complete heart block.Male gender,history of smoking,and history of COPD were more common in the primary angioplasty group.The rest of the clinical features were not significantly different between the two groups.Creatinine,potassium and troponin levels were insignificantly higher in the primary angioplasty group and hemoglobin,blood glucose and LVEF levels were insignificantly higher in the thrombolytic group.In-hospital mortality was not significantly different between the thrombolytic group (29%) and the primary angioplasty group (30%) (p = 0.96).However, the overall incidence of in-hospital events was significantly lower in the thrombolytic group.