Page 36 - BH-1-1

Brain & Heart Atropine can reducing reperfusion vagal reflex in STEMI

Table 2. Baseline characteristics of the low‑dose group and the high‑dose group
Variables Low‑dose group High‑dose group P‑value
(n = 40) (n = 30)
Age (years) 60.50 ± 11.59 63.17 ± 14.53 0.396
Male, n (%) 30 (75.0) 27 (90.0) 0.110
BMI (kg/m ) 24.0 ± 3.2 24.8 ± 3.5 0.857
2
Smoker, n (%) 28 (70.0) 25 (83.3) 0.198
Hypertension, n (%) 14 (35.0) 7 (23.3) 0.292
Diabetes mellitus, n (%) 11 (27.5) 7 (23.3) 0.693
Stoke, n (%) 1 (2.5) 0 1
EF (%) 57.82 ± 7.21 60.67 ± 3.06 0.200
Single branch lesion, n (%) 16 (40.0) 7 (23.3) 0.142
Right coronary atherosclerosis, n (%) 35 (85.0) 29 (96.7) 0.107
Proximal 5 (12.5) 3 (10.0) 1
Mid 9 (22.5) 10 (33.3) 0.313
Distal 5 (12.5) 6 (20.0) 0.394
Chest pain (min) 300 (180.00, 519.00) 300 (216.00, 720.00) 0.494
Door-to-balloon (min) 80 (52.75, 99.75) 97 (70.50, 114.25) 0.054
BMI: Body mass index; LVEF: Left ventricular ejection fraction

Table 3. Reperfusion vagal reflex‑related events in the Table 5. Reperfusion vagal reflex‑related events in the
experimental group and the control group low‑dose group and the high‑dose group

Variables Experimental Control P‑value Variables Low‑dose High‑dose P‑value
group group group group
(n=70) (n=72) (n = 40) (n = 30)
Bradycardia, n (%) 17 (24.3) 33 (45.8) 0.007 Bradycardia, n (%) 14 (35.0) 3 (10.0) 0.016
Hypotension, n (%) 13 (18.6) 29 (40.3) 0.005 Hypotension, n (%) 11 (27.5) 2 (6.7) 0.027
Ventricular tachycardia, n (%) 3 (4.3) 14 (19.4) 0.005 Ventricular tachycardia, n (%) 10 (25.0) 2 (6.7) 0.044
Ventricular fibrillation, n (%) 6 (8.6) 15 (20.8) 0.040 Ventricular fibrillation, n (%) 6 (15.0) 0 (0) 0.034
Temporary pacemaker, n (%) 10 (14.3) 21 (29.2) 0.032 Temporary pacemaker, n (%) 9 (22.5) 1 (3.3) 0.036

Table 4. Secondary arrhythmia and extracardiac symptoms most of these events can be corrected within 30 min
during and after percutaneous coronary intervention after corresponding treatment is given; however, the
Variables Experimental Control P‑value risk and difficulty of the procedure as well as the cost of
group group hospitalization could increase. Compared with that in the
(n = 70) (n = 72) normal heart, the insertion of a temporary pacemaker
Arrhythmia, n (%) 18 (25.7) 25 (34.7) 0.243 during emergency PCI for inferior STEMI is associated
Sinus tachycardia, n (%) 17 (24.3) 15 (25.8) 0.623 with higher risks, which include pericardial tamponade
Frequent PVC, n (%) 0 (0) 3 (4.2) 0.245 caused by intraoperative perforation of the right ventricle
VT/VF, n (%) 0 (0) 7 (9.7) 0.013 and ventricular arrhythmias caused by catheter activation
AF, n (%) 1 (1.4) 0 (0) 0.049 or the differences in the refractory periods between
Purkinje fibers and myocardial cells .
[17]
Nausea and vomiting, n (%) 3 (4.3) 4 (5.6) 1.000
Urinary retention, n (%) 3 (4.3) 1 (1.4) 0.363 In this study, atropine preconditioning alleviated the
vagal reflex; prevented hypotension, bradycardia, nausea,
AF: Atrial fibrillation; PVC: Premature ventricular contraction;
VF: Ventricular fibrillation; VT: Ventricular tachycardia and vomiting; decreased the incidence of ventricular
tachycardia or fibrillation; and improved the safety of the
artery is reperfusion vagal reflex. When hypotension, procedure. The previous studies have indicated that low
bradycardia, and other reperfusion reactions occur, doses of atropine (0.5 – 1 mg) can temporarily slow down

Volume 1 Issue 1 (2023) 5 https://doi.org/10.36922/bh.193