Cargando…
Prognostic Impact of Acute Myocardial Infarction in Patients Presenting With Ventricular Tachyarrhythmias and Aborted Cardiac Arrest
BACKGROUND: The study sought to assess the prognostic impact of acute myocardial infarction (AMI) with and without ST‐segment–elevation myocardial infarction (STEMI and NSTEMI) in patients with ventricular tachyarrhythmias and sudden cardiac arrest (SCA) on admission. METHODS AND RESULTS: A large re...
Autores principales: | , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404887/ https://www.ncbi.nlm.nih.gov/pubmed/30371335 http://dx.doi.org/10.1161/JAHA.118.010004 |
_version_ | 1783400972691701760 |
---|---|
author | Behnes, Michael Mashayekhi, Kambis Weiß, Christel Nienaber, Christoph Lang, Siegfried Reiser, Linda Bollow, Armin Taton, Gabriel Reichelt, Thomas Ellguth, Dominik Engelke, Niko Schupp, Tobias Ansari, Uzair El‐Battrawy, Ibrahim Rusnak, Jonas Akin, Muharrem Borggrefe, Martin Akin, Ibrahim |
author_facet | Behnes, Michael Mashayekhi, Kambis Weiß, Christel Nienaber, Christoph Lang, Siegfried Reiser, Linda Bollow, Armin Taton, Gabriel Reichelt, Thomas Ellguth, Dominik Engelke, Niko Schupp, Tobias Ansari, Uzair El‐Battrawy, Ibrahim Rusnak, Jonas Akin, Muharrem Borggrefe, Martin Akin, Ibrahim |
author_sort | Behnes, Michael |
collection | PubMed |
description | BACKGROUND: The study sought to assess the prognostic impact of acute myocardial infarction (AMI) with and without ST‐segment–elevation myocardial infarction (STEMI and NSTEMI) in patients with ventricular tachyarrhythmias and sudden cardiac arrest (SCA) on admission. METHODS AND RESULTS: A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT), fibrillation (VF), and sudden cardiac arrest (SCA) on admission from 2002 to 2016. AMI versus non‐AMI and STEMI versus NSTEMI were compared applying multivariable Cox regression models and propensity‐score matching for evaluation of the primary prognostic end point defined as long‐term all‐cause mortality at 2.5 years. Secondary end points were 30 days all‐cause mortality, cardiac death at 24 hours, in hospital death, and recurrent percutaneous coronary intervention (re‐PCI) at 2.5 years. In 2813 unmatched high‐risk patients with ventricular tachyarrhythmias and SCA, AMI was present in 29% (10% STEMI, 19% NSTEMI) with higher rates of VF (54% versus 31%) and SCA (35% versus 26%), whereas VT rates were higher in non‐AMI (56% versus 30%) (P < 0.05). AMI‐related VT ≥48 hours was associated with higher mortality (log rank P = 0.001). Multivariable Cox regression models revealed non‐AMI (hazard ratio = 1.458; P = 0.001) and NSTEMI (hazard ratio = 1.460; P = 0.036) associated with increasing long‐term all‐cause mortality at 2.5 years, which was also proven after propensity‐score matching (non‐AMI versus AMI: 55% versus 43%, log rank P = 0.001, hazard ratio = 1.349; NSTEMI versus STEMI: 45% versus 34%, log rank P = 0.047, hazard ratio = 1.372). Secondary end points including 30 days and in‐hospital mortality, as well as re‐PCI were higher in non‐AMI patients. CONCLUSIONS: In high‐risk patients presenting with ventricular tachyarrhythmias and SCA, non‐AMI revealed higher mortality than AMI, respectively NSTEMI than STEMI, alongside AMI‐related VT ≥48 hours. |
format | Online Article Text |
id | pubmed-6404887 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-64048872019-03-19 Prognostic Impact of Acute Myocardial Infarction in Patients Presenting With Ventricular Tachyarrhythmias and Aborted Cardiac Arrest Behnes, Michael Mashayekhi, Kambis Weiß, Christel Nienaber, Christoph Lang, Siegfried Reiser, Linda Bollow, Armin Taton, Gabriel Reichelt, Thomas Ellguth, Dominik Engelke, Niko Schupp, Tobias Ansari, Uzair El‐Battrawy, Ibrahim Rusnak, Jonas Akin, Muharrem Borggrefe, Martin Akin, Ibrahim J Am Heart Assoc Original Research BACKGROUND: The study sought to assess the prognostic impact of acute myocardial infarction (AMI) with and without ST‐segment–elevation myocardial infarction (STEMI and NSTEMI) in patients with ventricular tachyarrhythmias and sudden cardiac arrest (SCA) on admission. METHODS AND RESULTS: A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT), fibrillation (VF), and sudden cardiac arrest (SCA) on admission from 2002 to 2016. AMI versus non‐AMI and STEMI versus NSTEMI were compared applying multivariable Cox regression models and propensity‐score matching for evaluation of the primary prognostic end point defined as long‐term all‐cause mortality at 2.5 years. Secondary end points were 30 days all‐cause mortality, cardiac death at 24 hours, in hospital death, and recurrent percutaneous coronary intervention (re‐PCI) at 2.5 years. In 2813 unmatched high‐risk patients with ventricular tachyarrhythmias and SCA, AMI was present in 29% (10% STEMI, 19% NSTEMI) with higher rates of VF (54% versus 31%) and SCA (35% versus 26%), whereas VT rates were higher in non‐AMI (56% versus 30%) (P < 0.05). AMI‐related VT ≥48 hours was associated with higher mortality (log rank P = 0.001). Multivariable Cox regression models revealed non‐AMI (hazard ratio = 1.458; P = 0.001) and NSTEMI (hazard ratio = 1.460; P = 0.036) associated with increasing long‐term all‐cause mortality at 2.5 years, which was also proven after propensity‐score matching (non‐AMI versus AMI: 55% versus 43%, log rank P = 0.001, hazard ratio = 1.349; NSTEMI versus STEMI: 45% versus 34%, log rank P = 0.047, hazard ratio = 1.372). Secondary end points including 30 days and in‐hospital mortality, as well as re‐PCI were higher in non‐AMI patients. CONCLUSIONS: In high‐risk patients presenting with ventricular tachyarrhythmias and SCA, non‐AMI revealed higher mortality than AMI, respectively NSTEMI than STEMI, alongside AMI‐related VT ≥48 hours. John Wiley and Sons Inc. 2018-09-25 /pmc/articles/PMC6404887/ /pubmed/30371335 http://dx.doi.org/10.1161/JAHA.118.010004 Text en © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Behnes, Michael Mashayekhi, Kambis Weiß, Christel Nienaber, Christoph Lang, Siegfried Reiser, Linda Bollow, Armin Taton, Gabriel Reichelt, Thomas Ellguth, Dominik Engelke, Niko Schupp, Tobias Ansari, Uzair El‐Battrawy, Ibrahim Rusnak, Jonas Akin, Muharrem Borggrefe, Martin Akin, Ibrahim Prognostic Impact of Acute Myocardial Infarction in Patients Presenting With Ventricular Tachyarrhythmias and Aborted Cardiac Arrest |
title | Prognostic Impact of Acute Myocardial Infarction in Patients Presenting With Ventricular Tachyarrhythmias and Aborted Cardiac Arrest |
title_full | Prognostic Impact of Acute Myocardial Infarction in Patients Presenting With Ventricular Tachyarrhythmias and Aborted Cardiac Arrest |
title_fullStr | Prognostic Impact of Acute Myocardial Infarction in Patients Presenting With Ventricular Tachyarrhythmias and Aborted Cardiac Arrest |
title_full_unstemmed | Prognostic Impact of Acute Myocardial Infarction in Patients Presenting With Ventricular Tachyarrhythmias and Aborted Cardiac Arrest |
title_short | Prognostic Impact of Acute Myocardial Infarction in Patients Presenting With Ventricular Tachyarrhythmias and Aborted Cardiac Arrest |
title_sort | prognostic impact of acute myocardial infarction in patients presenting with ventricular tachyarrhythmias and aborted cardiac arrest |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404887/ https://www.ncbi.nlm.nih.gov/pubmed/30371335 http://dx.doi.org/10.1161/JAHA.118.010004 |
work_keys_str_mv | AT behnesmichael prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT mashayekhikambis prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT weißchristel prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT nienaberchristoph prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT langsiegfried prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT reiserlinda prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT bollowarmin prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT tatongabriel prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT reicheltthomas prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT ellguthdominik prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT engelkeniko prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT schupptobias prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT ansariuzair prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT elbattrawyibrahim prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT rusnakjonas prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT akinmuharrem prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT borggrefemartin prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest AT akinibrahim prognosticimpactofacutemyocardialinfarctioninpatientspresentingwithventriculartachyarrhythmiasandabortedcardiacarrest |