Different Reperfusion Timing and Ventricular Arrhythmias in STEMI Patients

Study Overview
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Brief Summary
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The aim of this study was to investigate the association between different reperfusion timing and ventricular arrhythmias (VAs) to provide evidence for clinical decision-making for patients with ST-segment elevation myocardial infarction (STEMI). All the participants included in the study were diagnosed with STEMI according to the 4th universal definition of myocardial infarction, with a follow-up of 1, 6, 12 months, respectively. Symptom onset-to-reperfusion timing (SO2RT) and 24h-dynamic electrocardiogram parameters were recorded to compare different SO2RT and VAs during 3 follow-up visits.

Detailed Description
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It is Class I recommendation that STEMI require emergency revascularization with no delay. However, arrhythmias after acute myocardial infarction (AMI), particularly VAs, also occur in the early post-MI phase, leading to increased mortality. Previous studies have shown benefits of late reperfusion to electrical stability. The aim of this study was to investigate the association between different reperfusion timing and VAs to provide evidence for clinical decision-making for STEMI. In this multicenter, prospective, observational study, STEMI participants from July 2019 to December 2020 confirmed according to the 4th universal definition of myocardial infarction were enrolled, with a follow-up of 1, 6, 12 months, respectively. SO2RT was defined as the time interval between symptom onset and reperfusion timing which referred to the timing when coronary angiography showed Thrombolysis In Myocardial Infarction (TIMI) blood flow level 2 3 immediately after percutaneous coronary intervention (PCI). The primary end point was VAs on 24h-dynamic electrocardiogram. Secondary outcomes included a composite of death from coronary heart disease, fetal of non-fetal ischemic stroke, revascularization, or chest pain requiring readmission.

Official Title
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Association of Reperfusion Timing With Short- and Medium-term Ventricular Arrhythmias in Patients With ST-segment Elevation Myocardial Infarction: A Prospective Observational Study

Conditions
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ST Elevation Myocardial Infarction, Arrhythmia Ventricular

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: STEMI patients undergoing coronary angiography and PCI; can complete 3 follow-up visits well. Exclusion Criteria: without PCI; undergoing thrombolytic therapy; mental diseases; renal failure; stroke sequelae; tumor and a history of revascularization.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Early reperfusion group<br>All patients hospitalized and diagnosed as STEMI according to the 4th universal definition of myocardial infarction underwent coronary angiography and PCI treatment. Patients with SO2RT<24 hours were assigned to Early reperfusion group. | |
| Intermediate reperfusion group<br>All patients hospitalized and diagnosed as STEMI according to the 4th universal definition of myocardial infarction underwent coronary angiography and PCI treatment. Patients with SO2RT ranging from 24 hours to 7days were assigned to Intermediate reperfusion group. | |
| Late reperfusion group<br>All patients hospitalized and diagnosed as STEMI according to the 4th universal definition of myocardial infarction underwent coronary angiography and PCI treatment. Patients with SO2RT>7days were assigned to Late reperfusion group. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| VAs | The incidence of ventricular arrhythmias on 24h-dynamic electrocardiogram. | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Death from coronary heart disease | The incidence of death from coronary heart disease during follow-ups. | 12 months | 
| Fetal of non-fetal ischemic stroke | The incidence of fetal of non-fetal ischemic stroke during follow-ups. | 12 months | 
| Revascularization | The incidence of revascularization during follow-ups. | 12 months | 
| Chest pain requiring readmission | The incidence of chest pain requiring readmission during follow-ups. | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Symptom Onset-to-Reperfusion Timing (SO2RT), ST Elevation Myocardial Infarction, Arrhythmia Ventricular, Percutaneous Coronary Intervention, Early Reperfusion