Early and late ventricular tachyarrhythmias complicating acute myocardial infarction were associated with increased in-hospital mortality (HR 3.84 and HR 8.23, respectively; both P<0.001).
Cohort (n=7,669)
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Does the occurrence of early or late ventricular tachyarrhythmias increase mortality risk in patients with acute coronary syndrome?
In patients with acute coronary syndrome, both early and late ventricular tachyarrhythmias increase in-hospital mortality, but only late VTA (primarily sustained VT) is associated with long-term adverse outcomes.
Hazard Ratio: 3.84 (95% CI 1.77–6.78)
valor p: p=<0.001
AIM: To evaluate the incidence and prognostic implications of ventricular tachyarrhythmias (VTAs) complicating acute myocardial infarction (MI). METHODS AND RESULTS: We evaluated 7669 MI patients ST elevation (n = 3573) and non-ST-elevation acute coronary syndrome (ACS) (n = 4096) from the Acute Coronary Syndrome Israeli Survey for the incidence of VTA. Ventricular tachyarrhythmia occurred in 3.8% of patients 2.1% early (≤ 48 h) and 1.7% late (>48 h) VTA. In-hospital mortality rates were higher for patients with VTA when compared with patients with no VTA (P < 0.001). Consistent with these findings, multivariable analysis demonstrated that early and late VTAs were associated with increased risk of in-hospital death hazard ratio (HR) = 3.84; 95% confidence interval (CI) 1.77-6.78, P < 0.001, and HR = 8.23; 95% CI 4.84-13.98, P < 0.001, respectively. In contrast, post-discharge outcomes demonstrated that only late VTA was independently associated with a significant increased risk of 30-day mortality (HR = 5.17; 95% CI 1.54-17.27, P = 0.007) with a trend towards an increased 1-year mortality risk (HR = 1.69; 95% CI 0.79-3.62, P = 0.17). The long-term risk associated with in-hospital VTA was driven by sustained ventricular tachycardia (VT) (HR = 3.28; 95% CI 1.92-5.60, P < 0.001) but not ventricular fibrillation (HR = 1.27; 95% CI 0.65-2.49, P = 0.47). CONCLUSIONS: Our findings suggest that in patients with ACS, both early and late VTAs are associated with an increased risk of in-hospital mortality. However, only late VTA, mostly sustained VT, is associated with long-term adverse outcome.
Orvin et al. (Thu,) conducted a cohort in Acute myocardial infarction (n=7,669). Ventricular tachyarrhythmias (VTAs) vs. No VTA was evaluated on In-hospital death (HR 3.84, 95% CI 1.77-6.78, p=<0.001). Early and late ventricular tachyarrhythmias complicating acute myocardial infarction were associated with increased in-hospital mortality (HR 3.84 and HR 8.23, respectively; both P<0.001).