0019: High-degree atrioventricular block complicating ST-segment elevation myocardial infarction in the contemporary era: data from the ORBI prospective French regional registry

Background High-degree atrioventricular block (HAVB) is a common complication of ST-segment elevation myocardial infarction (STEMI). HAVB in STEMI is historically considered as a marker of worse outcome but overall data about HAVB in the contemporary era of mechanical reperfusion and potent antiplatelet therapies are scarce. Aim We aimed at analyzing incidence, clinical correlates and impact on inhospital outcomes of HAVB in a large prospective registry (ORBI) of modern management of STEMI with a special focus on potential differences between patients with HAVB on admission and those who developed HAVB during hospitalization. Methods All patients enrolled in ORBI between June 2006 and December 2013 were included in the present analysis and were divided into 3 groups: patients without HAVB at any time, patients with HAVB on admission and those who developed HAVB during hospitalization. Results 6662 patients (age: 62.0 [52.0-74.0]; male: 76.3%) were included in the present analysis. HAVB was documented in 3.5% of patients, present on admission in 63.7% of patients and occurring during hospitalization in 36.3%. Patients with HAVB on admission or occurring during the first 24h of hospitalization had higher in-hospital mortality rates (18.1% and 28.6% respectively) than patients without (4.5%) or with HAVB occurring beyond the first 24h of hospitalization (8.0%). However by multivariable analysis, HAVB was not independently associated with in-hospital mortality. Conclusion Patients with HAVB had a higher mortality rate than patients without. However HAVB is not an independent predictor of in-hospital mortality. Download high-res image (214KB) Download full-size image Abstract 0019 – Figure: Multivariable analysis