Clinical, laboratory and echocardiographic features of patients with ST-elevation myocardial infarction complicated by ventricular arrhythmias: an observational study

Abstract

Background: Early malignant ventricular arrhythmias (VAs) during ST-elevation myocardial infarction (STEMI) significantly contribute to in-hospital mortality but appear to have little impact on long-term prognosis, likely because the arrhythmic substrate is reversed after revascularization. Methods: The study included 91 patients with STEMI who were admitted to the Grodno State Cardiological Center for treatment between February 2024 and February 2025. Group 1 included 64 patients with STEMI, whereas Group 2 included 29 patients with STEMI and ventricular arrhythmias (sustained VT or VF). All patients underwent clinical, laboratory, and instrumental examinations, including coronary angiography. Statistical analyses were performed using STATISTICA 12.0 software. Results: Among 29 patients with VAs, six had ventricular fibrillation treated with electrical cardioversion, three had sustained VT, and 20 had episodes of non-sustained VT. According to the results of coronary angiography, 24 patients had undergone percutaneous coronary intervention, and five patients had stenosis of the left main coronary artery; therefore, they underwent coronary artery bypass graft operation. Patients with STEMI and ventricular tachyarrhythmias were characterized by a higher prevalence of inferior localization of MI (p=0.001), higher WBCs counts (0.008), higher glucose levels (p=0.008), higher troponin levels (p=0.004), lower left ventricular ejection fraction in both M- and B-modes (p=0.001), and higher contractility index (p=0.001). Conclusions: These results demonstrates that inflammatory markers, myocardial injury, compromised ventricular function, and metabolic disruptions depict that the pathophysiology of arrhythmias in STEMI patients, highlighting the significance of early observation and timely treatment program to decrease the arrhythmic risk.