Katia Orvin1, Alon Eisen2, Ilan Goldenberg3, Shmuel Gottlieb3, Ran Kornowski2, Shlomi Matetzky3, Gregory Golovchiner2, Jairo Kuznietz2, Natalie Gavrielov-Yusim2, Amit Segev3, Boris Strasberg2, Moti Haim2. 1. Cardiology Department, Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinsky St. 49100, Petach Tikva, Tel Aviv, Israel katiaorvin@gmail.com. 2. Cardiology Department, Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinsky St. 49100, Petach Tikva, Tel Aviv, Israel. 3. Neufeld Cardiac Research Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
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. Published on behalf of the European Society of Cardiology. All rights reserved.
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. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Robert Kowalik; Marek Gierlotka; Krzysztof Ozierański; Przemysław Trzeciak; Anna Fojt; Piotr Feusette; Agnieszka Tycińska; Grzegorz Opolski; Marcin Grabowski; Mariusz Gąsior Journal: J Clin Med Date: 2022-01-26 Impact factor: 4.241
Authors: Orianne Weizman; Eloi Marijon; Kumar Narayanan; Serge Boveda; Pascal Defaye; Raphael Martins; Jean-Claude Deharo; Gabriel Laurent; Didier Klug; Nicolas Sadoul; Meleze Hocini; Nicolas Mansencal; Frédéric Anselme; Antoine Da Costa; Philippe Maury; Jean Ferrières; François Schiele; Tabassome Simon; Nicolas Danchin Journal: J Am Heart Assoc Date: 2022-08-26 Impact factor: 6.106