the usefulness of assessing heart rate variability in patients with acute myocardial infarction

Conditions: Myocardial Infarction; Autonomic Dysfunction

Summary: aims * heart rate variability (hrv) assessment in patients with acute myocardial infarction who undergo primary percutaneous coronary intervention (pci); * measurement of hrv using a device approved for medical use in europe; * assessment of the correlation between hrv and short- and long-term adverse cardiovascular events (composite of all-cause mortality and major adverse cardiovascular events - mace; ventricular arrhythmias; hospital admissions for heart failure; left ventricular systolic and diastolic disfunction; mace in special subgroups of patients - elderly, diabetes mellitus, chronic kidney disease) in patients treated by primary pci for acute myocardial infarction; * creating a registry of hrv parameters measured in a contemporary cohort of patients with acute myocardial infarction.

the following data will be collected: * general demographic data; * time from chest pain onset to primary pci; * comorbidities (ischemic heart disease, arterial hypertension, previous pci or coronary artery bypass surgery - cabg, heart failure, peripheral artery disease, atrial fibrillation, stroke, diabetes mellitus, kidney disease); * cardiovascular risk factors (age, body mass index, smoking, abdominal perimeter, sedentarism, gender, inflammation); * cardiac rhythm derived from electrocardiographic data; * hrv time- and frequency domain parameters (respectively, sdnn, sdann, rmssd and lf, hf, lf/hf ratio); * routine biological data and biomarkers, including creatine kinase-mb (ck-mb), aspartate transaminase (ast), lactate dehydrogenase (ldh) and cardiac-specific troponin; * left ventricular ejection fraction at admission, at discharge and at follow-up (1 month, 6 months and 1 year); * initial and final thrombolysis in myocardial infarction (timi) flow; * type of stent used for coronary angioplasty; * global registry of acute coronary events (grace) score; * syntax score ii in case of three-vessel coronary disease or involving left main stem; * in-hospital, one month and long-term clinical outcomes (composite of all-cause mortality and major adverse cardiovascular events - mace; ventricular arrhythmias; hospital admissions for heart failure; left ventricular systolic and diastolic disfunction; mace in special subgroups of patients - elderly, diabetes mellitus, chronic kidney disease).

Eligibility criteria:
inclusion criteria: * patients with st-elevation myocardial infarction (stemi) treated with primary pci within 12 hours from symptoms onset; * patients in sinus rhythm; * patients who have read and signed the standard informed consent regarding enrolment in the study. exclusion criteria: * unconscious or intubated patients who are unable to sign the standard informed consent; * patients with atrial fibrillation; * patients with sinus node dysfunction or atrioventricular block of any degree; * frequent premature supraventricular or ventricular contractions; * paced ventricular rhythm; * patients treated with positive inotropic and chronotropic drugs; * history of myocardial infarction or myocardial revascularization (pci or cabg); * patients refusal.

Keywords: heart rate variability percutaneous coronary intervention drug-eluting stents risk assessment prognosis major adverse cardiovascular events left ventricular ejection fraction secondary prevention