title: Prognostic role of heart rate variability in patients with ST-segment elevation acute myocardial infarction treated by primary angioplasty.
abstract: OBJECTIVE
  The aim of our study was to assess the prognostic value of heart rate variability (HRV) in ST-segment elevation acute myocardial infarction (STEMI) patients treated by percutaneous transluminal coronary angioplasty (PTCA) and optimal medical therapy.
  
  
  METHODS
  We enrolled 182 consecutive patients with a first STEMI (59.1 ± 11 years; 82.4% men) treated by primary PTCA. HRV was assessed on 24-hour Holter ECG recordings before discharge and 1 and 6 months after discharge. The primary end point was the occurrence of major clinical events (MCE), defined as death or new acute myocardial infarction (AMI).
  
  
  RESULTS
  At a follow-up of 42 ± 23 months, MCE occurred in 14 patients (7.6%; 3 deaths and 11 re-AMIs). HRV parameters before discharge were significantly lower in patients with MCE, with standard deviation of all RR intervals (SDNN) and very low frequency and low frequency (LF) amplitude being the most predictive variables. HRV assessed at follow-up instead did not significantly predict MCE. At multivariate analysis, only SDNN (HR 0.97; p = 0.02) and LF (HR 0.90; p = 0.04) remained significantly associated with MCE. Lower tertile SDNN and LF values were associated with a multivariate HR of 3.91 (p = 0.015) and of 2.92 (p = 0.048), respectively. Similar results were observed considering re-AMI only as the end point.
  
  
  CONCLUSIONS
  In STEMI patients treated by PTCA, HRV assessed before discharge was an independent predictor of MCE and re-AMI.
authors: Cardiology Institute, Catholic University of the Sacred Heart, Rome, Italy.
authors: Ilaria
authors: I
authors: Coviello
authors: Gaetano
authors: G
authors: Pinnacchio
authors: Marianna
authors: M
authors: Laurito
authors: Alessandra
authors: A
authors: Stazi
authors: Irma
authors: I
authors: Battipaglia
authors: Lucy
authors: L
authors: Barone
authors: Roberto
authors: R
authors: Mollo
authors: Giulio
authors: G
authors: Russo
authors: Angelo
authors: A
authors: Villano
authors: Alfonso
authors: A
authors: Sestito
authors: Gaetano Antonio
authors: GA
authors: Lanza
authors: Filippo
authors: F
authors: Crea
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D018572:Disease-Free Survival; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy; D011379:Prognosis