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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...

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Autores principales: 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
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
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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.
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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
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