Impact of Short-Term Heart Rate Variability in Patients with STEMI Treated by Delayed versus Immediate Stent in Primary Percutaneous Coronary Intervention: A Prospective Cohort Study

Abstract

Objective. Patients with ST-segment elevated myocardial infarction (STEMI) have been treated with the delayed stent strategy to reduce the occurrence of postoperative no-reflow and improve the recovery of postoperative cardiac function. However, the effects of electrocardiac activity and autonomic nerve function after primary percutaneous coronary intervention (pPCI) have been rarely reported. The purpose of this study was to investigate the effects of short-term heart rate variability (HRV) in patients with STEMI treated by immediate stent (IS) and delayed stent (DS) strategy. Methods. A total of 178 patients with STEMI were divided into 124 cases (69.66%) in the IS group and 54 cases (30.34%) in the DS group from July 2019 to September 2021. The mean heart rate, premature ventricular contraction (PVC), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVED), and HRV indexes were compared between the two groups. Results. In terms of cardiac electrical stability, the number of PVCs, the percentage of PVCs, and the number of paired PVCs in the DS group were lower than those in the IS group. In terms of HRV, high frequency (HF) and standard deviation of all NN (SDNN) intervals were higher in the patients with DS strategy than IS strategy. There were no significant differences in the LVED and LVEF between the two groups. Conclusion. Compared to the IS strategy, the DS strategy in pPCI in patients with STEMI has advantages in postoperative cardiac electrical stability and short-term cardiac autonomic nerve function, with no difference in postoperative short-term cardiac function.

precise-dapt score as a predictor of contrast induced nephropathy in acute coronary syndrome patients undergoing per cutaneous coronary intervention

“…Based on present rules, the usual care therapy for ACS is a diagnostic angiography then by PCI, that is intended to return coronary blood flow immediately [14] . In the present study, Hb and Hct were considerably lower in cases had CIN than who had not (p =0.012, and 0.007 respectively).…”

“…The Mehran CIN risk score included eight clinical and procedural variables: presence of hypotension, congestive heart failure, chronic kidney disease, diabetes, age >75 years, anemia, requirement of intra-aortic balloon pump, and the volume of contrast agent used. Patients were categorized into four risk groups based on MS: low (≤ 5), moderate (6)(7)(8)(9)(10), high (11)(12)(13)(14)(15), and very high (≥ 16). Risk groups were compared for all study variables.…”