Factors associated with temporary pacing insertion in patients with inferior ST-segment elevation myocardial infarction

PLoS One. 2021 May 3;16(5):e0251124. doi: 10.1371/journal.pone.0251124. eCollection 2021.

Abstract

Background: High-degree atrioventricular block (HAVB) is a prognostic factor for survival in patients with inferior ST-segment elevation myocardial infarction (STEMI). However, there is little information about factors associated with temporary pacing (TP). The aim of this study was to find factors associated with TP in patients with inferior STEMI.

Methods: We included 232 inferior STEMI patients, and divided those into the TP group (n = 46) and the non-TP group (n = 186). Factors associated with TP were retrospectively investigated using multivariate logistic regression model.

Results: The incidence of right ventricular (RV) infarction was significantly higher in the TP group (19.6%) than in the non-TP group (7.5%) (p = 0.024), but the incidence of in-hospital death was similar between the 2 groups (4.3% vs. 4.8%, p = 1.000). Long-term major adverse cardiovascular events (MACE), which were defined as a composite of all-cause death, non-fatal myocardial infarction (MI), target vessel revascularization (TVR) and readmission for heart failure, were not different between the 2 groups (p = 0.100). In the multivariate logistic regression analysis, statin at admission [odds ratio (OR) 0.230, 95% confidence interval (CI) 0.062-0.860, p = 0.029], HAVB at admission (OR 9.950, 95% CI 4.099-24.152, p<0.001), and TIMI-thrombus grade ≥3 (OR 10.762, 95% CI 1.385-83.635, p = 0.023) were significantly associated with TP.

Conclusion: Statin at admission, HAVB at admission, and TIMI-thrombus grade ≥3 were associated with TP in patients with inferior STEMI. Although the patients with TP had the higher incidence of RV infarction, the incidence of in-hospital death and long-term MACE was not different between patients with TP and those without.

MeSH terms

  • Aged
  • Atrioventricular Block / mortality
  • Atrioventricular Block / surgery
  • Cardiac Pacing, Artificial / methods
  • Cardiac Pacing, Artificial / mortality
  • Female
  • Heart Ventricles / pathology
  • Hospital Mortality
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Myocardial Infarction / mortality
  • Myocardial Infarction / surgery*
  • Odds Ratio
  • Percutaneous Coronary Intervention / mortality
  • Registries
  • Retrospective Studies
  • Risk Factors
  • ST Elevation Myocardial Infarction / mortality
  • ST Elevation Myocardial Infarction / surgery*
  • Treatment Outcome

Grants and funding

The authors received no specific funding for this work.