Symptom-to-balloon time and risk of ventricular arrhythmias in patients with STEMI undergoing percutaneous coronary intervention: The VERY-STEMI study

• Published in: International journal of cardiology. Cardiovascular risk and prevention Vol. 21; p. 200286
• Main Authors: Shan, Tian-Kai, Qian, Ling-Ling, Han, Xu-Dong, Deng, Bo, Gu, Ling-Feng, Wang, Ze-Mu, He, Ye, Zhu, Ting, Jing, Peng, Wang, Qi-Ming, Wang, Zi-Dun, Wang, Ru-Xing, Wang, Si-Bo, Wang, Lian-Sheng
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2024; Elsevier
• Subjects: Cardiovascular; Major adverse cardiovascular event; Real-world study; Research Paper; ST-Segment elevation myocardial infarction; Symptom-to-balloon time; Ventricular arrhythmia; Ventricular arrhythmia; Real-world study; ST-Segment elevation myocardial infarction; Major adverse cardiovascular event; Symptom-to-balloon time; triglyceride; RCS; LDL-C; low-density lipoprotein cholesterol; myocardial infarction; LVEF; HR; high-sensitivity C-reactive protein; left ventricular ejection fraction; HDL-C; percutaneous coronary intervention; NT-proBNP; MACE; high-density lipoprotein cholesterol; restricted cubic spline; STEMI; major adverse cardiovascular events; MI; BMI; cardiovascular disease; body mass index; CI; VA; CVD; TG; PCI; S2BT; hazard ratio; hsCRP; confidence interval; ST-segment elevation myocardial infarction; NT-pro-brain natriuretic peptide
• ISSN: 2772-4875; 2772-4875
• DOI: 10.1016/j.ijcrp.2024.200286

Ventricular arrhythmias (VAs) mainly occur in the early post-myocardial infarction (MI) period. However, studies examining the association between total myocardial ischemia time interval and the risk of new-onset VAs during a long-term follow-up are scarce. This study (symptom-to-balloon time and VEntricular aRrhYthmias in patients with STEMI, VERY-STEMI study) was a multicenter, observational cohort and real-world study, which included patients with ST-segment elevation MI (STEMI) undergoing percutaneous coronary intervention (PCI). The primary endpoint was cumulative new-onset VAs during follow-up. The secondary endpoints were the major adverse cardiovascular events (MACE) and changes in left ventricular ejection fraction (ΔLVEF, %). A total of 517 patients with STEMI were included and 236 primary endpoint events occurred. After multivariable adjustments, compared to patients with S2BT of 24 h-7d, those with S2BT ≤ 24 h and S2BT > 7d had a lower risk of primary endpoint. RCS showed an inverted U-shaped relationship between S2BT and the primary endpoint, with an S2BT of 68.4 h at the inflection point. Patients with S2BT ≤ 24 h were associated with a lower risk of MACE and a 4.44 increase in LVEF, while there was no significant difference in MACE and LVEF change between the S2BT > 7d group and S2BT of 24 h-7d group. S2BT of 24 h-7d in STEMI patients was associated with a higher risk of VAs during follow-up. There was an inverted U-shaped relationship between S2BT and VAs, with the highest risk at an S2BT of 68.4 h. •S2BT of 24 h-7d was associated with a higher risk of VAs in STEMI patients.•There was an inverted U-shaped relationship between S2BT and VAs.•The risk was highest when S2BT was 68.4 h.