Risk Factors for Ventricular Arrhythmias After Emergency Percutaneous Coronary Intervention in Elderly Patients with Acute Myocardial Infarction

Overview

Journal Am J Transl Res

Specialty General Medicine

Date 2024 Jun 17

PMID 38883350

Authors

Yajun He

Jilun Liu

Yue Zhang

Ye Tian

YuQiu Li

Erwei Liu

Rui Cao

Affiliations

Soon will be listed here.

Abstract

Objective: To explore the risk factors for ventricular arrhythmia after percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI).

Methods: A retrospective cohort of 201 elderly AMI patients who underwent PCI in the emergency department of No. 215 Hospital of Shaanxi Nuclear Industry from April 2020 to January 2023 was analyzed. The patients were randomly divided into a training set (n=134) for model development and a test set (n=67) for model validation. The training set was divided into a ventricular arrhythmia group (n=51) and a non-ventricular arrhythmia group (n=83), based on the occurrence of ventricular arrhythmia post-PCI. The factors affecting ventricular arrhythmias were analyzed by logistic regression and Lasso regression models.

Results: Lasso regression screened 12 characteristic factors at λ=0.1 se. In the training set, the area under the ROC curve (AUC) of the Lasso model for predicting ventricular arrhythmia was 0.954, which was significantly higher than 0.826 for the Logistic model (P < 0.001). In the test set, the AUC of the Lasso model was 0.962, which was also significantly higher than 0.825 for the Logistic model (P=0.003).

Conclusion: Compared to the logistic regression model, the Lasso regression model can more accurately predict the occurrence of ventricular arrhythmia after PCI in elderly AMI patients. The Lasso regression model constructed in this study can provide a reference for the clinical identification of high-risk elderly AMI patients and the development of targeted monitoring and treatment.

References

Dalager-Pedersen M, Sogaard M, Schonheyder H, Nielsen H, Thomsen R . Response to letter regarding article, "Risk for myocardial infarction and stroke after community-acquired bacteremia: a 20-year population-based cohort study". Circulation. 2015; 131(1):e9. DOI: 10.1161/CIRCULATIONAHA.114.012813. View

Alexander C, Bishop M, Gilchrist R, Burton F, Smith G, Myles R . Initiation of ventricular arrhythmia in the acquired long QT syndrome. Cardiovasc Res. 2022; 119(2):465-476. PMC: 10064840. DOI: 10.1093/cvr/cvac103. View

Wang X, Wei L, Wu Y, Yan J, Zhao L, Yue X . ST-segment elevation predicts the occurrence of malignant ventricular arrhythmia events in patients with acute ST-segment elevation myocardial infarction. BMC Cardiovasc Disord. 2023; 23(1):61. PMC: 9896671. DOI: 10.1186/s12872-023-03099-w. View

Wang J, He X, Bai Y, Du G, Cai M . Identification and validation of novel biomarkers affecting bladder cancer immunotherapy machine learning and its association with M2 macrophages. Front Immunol. 2022; 13:1051063. PMC: 9681792. DOI: 10.3389/fimmu.2022.1051063. View

Del Buono M, Montone R, Rinaldi R, Gurgoglione F, Meucci M, Camilli M . Clinical predictors and prognostic role of high Killip class in patients with a first episode of anterior ST-segment elevation acute myocardial infarction. J Cardiovasc Med (Hagerstown). 2021; 22(7):530-538. DOI: 10.2459/JCM.0000000000001168. View

Tan S, Pol D, Splatt L, Abrahams T, Mydin M, Nelson A . Diagnostic accuracy of reperfusion criteria following fibrinolysis for ST-elevation myocardial infarction. AsiaIntervention. 2023; 9(1):49-51. PMC: 10015478. DOI: 10.4244/AIJ-D-22-00036. View

Jimenez J, Banna S, Desai N . A Peculiar ST Elevation Mimicking STEMI. JAMA Intern Med. 2022; 183(2):158-159. DOI: 10.1001/jamainternmed.2022.5070. View

Milwidsky A, Greidinger D, Frydman S, Hochstadt A, Ifrach-Kashtan N, Mizrachi M . Echocardiographic Killip Classification. J Am Soc Echocardiogr. 2021; 35(3):287-294. DOI: 10.1016/j.echo.2021.10.012. View

Perera D, Morgan H, Ryan M, Dodd M, Clayton T, OKane P . Arrhythmia and Death Following Percutaneous Revascularization in Ischemic Left Ventricular Dysfunction: Prespecified Analyses From the REVIVED-BCIS2 Trial. Circulation. 2023; 148(11):862-871. PMC: 10487377. DOI: 10.1161/CIRCULATIONAHA.123.065300. View

10.

Lin W, Hsiung M, Yin W, Tsao T, Lai W, Huang K . Electrocardiography Score for Left Ventricular Systolic Dysfunction in Non-ST Segment Elevation Acute Coronary Syndrome. Front Cardiovasc Med. 2022; 8:764575. PMC: 8777009. DOI: 10.3389/fcvm.2021.764575. View

11.

Lim G . Sonothrombolysis improves PCI after STEMI. Nat Rev Cardiol. 2019; 16(6):320. DOI: 10.1038/s41569-019-0188-z. View

12.

Buiten R, Ploumen E . Drug-eluting stents for ST-segment elevation myocardial infarction: extending the biodegradable versus durable polymer debate. Lancet. 2023; 402(10416):1942-1943. DOI: 10.1016/S0140-6736(23)02297-3. View

13.

Rathod K, Comer K, Casey-Gillman O, Moore L, Mills G, Ferguson G . Early Hospital Discharge Following PCI for Patients With STEMI. J Am Coll Cardiol. 2021; 78(25):2550-2560. DOI: 10.1016/j.jacc.2021.09.1379. View

14.

Jollis J, Granger C, Zegre-Hemsey J, Henry T, Goyal A, Tamis-Holland J . Treatment Time and In-Hospital Mortality Among Patients With ST-Segment Elevation Myocardial Infarction, 2018-2021. JAMA. 2022; 328(20):2033-2040. PMC: 9638953. DOI: 10.1001/jama.2022.20149. View

15.

Pu J, Ding S, Ge H, Han Y, Guo J, Lin R . Efficacy and Safety of a Pharmaco-Invasive Strategy With Half-Dose Alteplase Versus Primary Angioplasty in ST-Segment-Elevation Myocardial Infarction: EARLY-MYO Trial (Early Routine Catheterization After Alteplase Fibrinolysis Versus Primary PCI in.... Circulation. 2017; 136(16):1462-1473. DOI: 10.1161/CIRCULATIONAHA.117.030582. View

16.

Seker T, Turkoglu C, Akkus O, Gur M . The relationship between visible thrombus aspiration material with no-reflow and in-hospital mortality ratio in patients with anterior ST-elevation myocardial infarction treated with primary percutaneous coronary intervention. Turk Kardiyol Dern Ars. 2019; 47(2):95-102. DOI: 10.5543/tkda.2019.49940. View

17.

Sajadieh A, Nielsen O, Rasmussen V, Hein H, Frederiksen B, Davanlou M . Ventricular arrhythmias and risk of death and acute myocardial infarction in apparently healthy subjects of age >or=55 years. Am J Cardiol. 2006; 97(9):1351-7. DOI: 10.1016/j.amjcard.2005.11.067. View

18.

Shao Z, Wang Z, Bi S, Zhang J . Establishment and validation of a nomogram for progression to diabetic foot ulcers in elderly diabetic patients. Front Endocrinol (Lausanne). 2023; 14:1107830. PMC: 10110969. DOI: 10.3389/fendo.2023.1107830. View

19.

Li Y, Liang Z, Qin L, Wang M, Wang X, Zhang H . Bivalirudin plus a high-dose infusion versus heparin monotherapy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a randomised trial. Lancet. 2022; 400(10366):1847-1857. DOI: 10.1016/S0140-6736(22)01999-7. View

20.

Cadrin-Tourigny J, Bosman L, Nozza A, Wang W, Tadros R, Bhonsale A . A new prediction model for ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy. Eur Heart J. 2022; 43(32):e1-e9. PMC: 9392651. DOI: 10.1093/eurheartj/ehac180. View