ABSTRACT
Objective To investigate clinical characteristics of patients with ST-elevation myocardial infarction (STEMI) and hypokalemia and the effects of hypokalemia on prognosis. Methods Consecutive 216 cases with STEMI who underwent emergency PCI were divided into group A (serum potassium ＜ 3.5 mmol/L) and group B (serum potassium＞3.5 mmol/L). Infarct site, infarct interrelated artery, peak level of CK-MB and cTnT were compared between two groups. Post-infarctional angina pectoris, arrhythmia, heart failure and cardiac death were compared. Results (1 )The percentage of anterior wall myocardial infarction , left anterior descending artery (LAD) lesions in group A were significantly higher than those in group B [61.2%(41/67) vs. 44.3%(66/149),55.2%(37/67)vs. 38.9%(58/149),P = 0.022,0.026]. The peak levels of CK-MB and cTnT in group A were significantly higher than those in group B [(194.39 ± 101.27) μg/L vs. (115.35 ±78.62)μg/L,(19.16 ±11.48)μg/L vs. (9.07 ±7.65) μg/L,P = 0.004,0.002].(2)Left ventricular ejection fraction in group A was significant lower than that in group B (P - 0.003). The incidence rates of post-infarctional angina pectoris, ventricular tachycardia, ventricular fibrillation and heart failure were significantly higher in group A [43.3%(29/67),32.8%(22/67), 11.9%(8/67),37.3%(25/67)] than those in group B [24.8%(37/149),18.1%(27/149),4.0%(6/149),20.8%(31/149)](P = 0.006, 0.017, 0.029, 0.010). Conclusions Hypokalemia is associated with infarct site and infarct interrelated artery. Hypokalemia has bad effect on prognosis of STEMI.
ABSTRACT
<p><b>OBJECTIVE</b>To assess the complications of percutaneous tansluminal septal myocardial ablation (PTSMA) for the treatment of hypertrophic obstructive cardiomyopathy (HOCM).</p><p><b>METHODS</b>Seventy-two patients with symptomatic left ventricular outflow tract obstruction were diagnosed by echocardiography or catheterization procedures. Absolute ethanol was injected into the target coronary artery branch (branches) for septal myocardial ablation. Documented complications were recorded.</p><p><b>RESULTS</b>Sixty-nine patients had severe chest pain, 19 developed different degrees of heart block during the periprocedural period, but only one developed a complete AV block, requiring permanent pace-maker implantation. Temporary right bundle branch block occurred in 50% of patients and permanent block occurred in 38.9% of patients. Acute inferior myocardial infarction occurred in six patients (8.3%) and acute anterior myocardial infarction occurred in one patient. During two-year follow-up of 24 cases, there were no deaths. All patients had improvement in heart function and none experienced heart failure.</p><p><b>CONCLUSION</b>The most common complication of PTSMA is right bundle branch block. The most significant complication of the procedure is heart block. PTSMA is a good technical, non-surgical treatment for HOCM.</p>