Influence of standard modifiable risk factors on ventricular tachycardia after myocardial infarction
BackgroundInducible ventricular tachycardia (VT) at electrophysiology study (EPS) predicts sudden cardiac death because of ventricular tachyarrhythmia, the single greatest cause of death within 2 years after myocardial infarction (MI).ObjectivesWe aimed to assess the association between standard mod...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1283382/full |
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| author | Tejas Deshmukh Tejas Deshmukh Joshua G. Kovoor Karen Byth Clara K. Chow Clara K. Chow Sarah Zaman Sarah Zaman James J. H. Chong James J. H. Chong Gemma A. Figtree Gemma A. Figtree Aravinda Thiagalingam Aravinda Thiagalingam Pramesh Kovoor Pramesh Kovoor |
| author_facet | Tejas Deshmukh Tejas Deshmukh Joshua G. Kovoor Karen Byth Clara K. Chow Clara K. Chow Sarah Zaman Sarah Zaman James J. H. Chong James J. H. Chong Gemma A. Figtree Gemma A. Figtree Aravinda Thiagalingam Aravinda Thiagalingam Pramesh Kovoor Pramesh Kovoor |
| author_sort | Tejas Deshmukh |
| collection | DOAJ |
| description | BackgroundInducible ventricular tachycardia (VT) at electrophysiology study (EPS) predicts sudden cardiac death because of ventricular tachyarrhythmia, the single greatest cause of death within 2 years after myocardial infarction (MI).ObjectivesWe aimed to assess the association between standard modifiable risk factors (SMuRFs) and inducible VT at EPS early after MI.MethodsConsecutive patients with left ventricle ejection fraction ≤40% on days 3–5 after ST elevation MI (STEMI) who underwent EPS were prospectively recruited. Positive EPS was defined as induced sustained monomorphic VT cycle length ≥200 ms for ≥10 s or shorter if hemodynamically compromised. The primary outcome was inducibility of VT at EPS, and the secondary outcome was all-cause mortality on follow-up.ResultsIn 410 eligible patients undergoing EPS soon (median of 9 days) after STEMI, 126 had inducible VT. Ex-smokers experienced an increased risk of inducible VT [multivariable logistic regression adjusted odds ratio (OR) 2.0, p = 0.033] compared with current or never-smokers, with comparable risk. The presence of any SMuRFs apart from being a current smoker conferred an increased risk of inducible VT (adjusted OR 1.9, p = 0.043). Neither the number of SMuRFs nor the presence of any SMuRFs was associated with mortality at a median follow-up of 5.4 years.ConclusionsIn patients with recent STEMI and impaired left ventricular function, the presence of any SMuRFs, apart from being a current smoker, conferred an increased risk of inducible VT at EPS. These results highlight the need to modify SMuRFs in this high-risk subset of patients. |
| first_indexed | 2024-03-11T16:06:57Z |
| format | Article |
| id | doaj.art-234cd5f0696f4527858ee775538c3246 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-11T16:06:57Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-234cd5f0696f4527858ee775538c32462023-10-24T23:21:40ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-10-011010.3389/fcvm.2023.12833821283382Influence of standard modifiable risk factors on ventricular tachycardia after myocardial infarctionTejas Deshmukh0Tejas Deshmukh1Joshua G. Kovoor2Karen Byth3Clara K. Chow4Clara K. Chow5Sarah Zaman6Sarah Zaman7James J. H. Chong8James J. H. Chong9Gemma A. Figtree10Gemma A. Figtree11Aravinda Thiagalingam12Aravinda Thiagalingam13Pramesh Kovoor14Pramesh Kovoor15Department of Cardiology, Westmead Hospital, Sydney, NSW, AustraliaCentre for Heart Research, Westmead Institute for Medical Research, University of Sydney, Westmead, Sydney, NSW, AustraliaUniversity of Adelaide, The Queen Elizabeth Hospital, Adelaide, SA, AustraliaResearch and Education Network, Western Sydney Local Health District, Westmead Hospital, Sydney, NSW, AustraliaDepartment of Cardiology, Westmead Hospital, Sydney, NSW, AustraliaResearch and Education Network, Western Sydney Local Health District, Westmead Hospital, Sydney, NSW, AustraliaDepartment of Cardiology, Westmead Hospital, Sydney, NSW, AustraliaResearch and Education Network, Western Sydney Local Health District, Westmead Hospital, Sydney, NSW, AustraliaDepartment of Cardiology, Westmead Hospital, Sydney, NSW, AustraliaCentre for Heart Research, Westmead Institute for Medical Research, University of Sydney, Westmead, Sydney, NSW, AustraliaKolling Institute, Royal North Shore Hospital, Sydney, NSW, AustraliaCharles Perkins Centre, University of Sydney, Sydney, NSW, AustraliaDepartment of Cardiology, Westmead Hospital, Sydney, NSW, AustraliaResearch and Education Network, Western Sydney Local Health District, Westmead Hospital, Sydney, NSW, AustraliaDepartment of Cardiology, Westmead Hospital, Sydney, NSW, AustraliaResearch and Education Network, Western Sydney Local Health District, Westmead Hospital, Sydney, NSW, AustraliaBackgroundInducible ventricular tachycardia (VT) at electrophysiology study (EPS) predicts sudden cardiac death because of ventricular tachyarrhythmia, the single greatest cause of death within 2 years after myocardial infarction (MI).ObjectivesWe aimed to assess the association between standard modifiable risk factors (SMuRFs) and inducible VT at EPS early after MI.MethodsConsecutive patients with left ventricle ejection fraction ≤40% on days 3–5 after ST elevation MI (STEMI) who underwent EPS were prospectively recruited. Positive EPS was defined as induced sustained monomorphic VT cycle length ≥200 ms for ≥10 s or shorter if hemodynamically compromised. The primary outcome was inducibility of VT at EPS, and the secondary outcome was all-cause mortality on follow-up.ResultsIn 410 eligible patients undergoing EPS soon (median of 9 days) after STEMI, 126 had inducible VT. Ex-smokers experienced an increased risk of inducible VT [multivariable logistic regression adjusted odds ratio (OR) 2.0, p = 0.033] compared with current or never-smokers, with comparable risk. The presence of any SMuRFs apart from being a current smoker conferred an increased risk of inducible VT (adjusted OR 1.9, p = 0.043). Neither the number of SMuRFs nor the presence of any SMuRFs was associated with mortality at a median follow-up of 5.4 years.ConclusionsIn patients with recent STEMI and impaired left ventricular function, the presence of any SMuRFs, apart from being a current smoker, conferred an increased risk of inducible VT at EPS. These results highlight the need to modify SMuRFs in this high-risk subset of patients.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1283382/fullmyocardial infarctionventricular tachycardiaelectrophysiology studystandard modifiable risk factorsLVEF (left ventricular ejection fraction) |
| spellingShingle | Tejas Deshmukh Tejas Deshmukh Joshua G. Kovoor Karen Byth Clara K. Chow Clara K. Chow Sarah Zaman Sarah Zaman James J. H. Chong James J. H. Chong Gemma A. Figtree Gemma A. Figtree Aravinda Thiagalingam Aravinda Thiagalingam Pramesh Kovoor Pramesh Kovoor Influence of standard modifiable risk factors on ventricular tachycardia after myocardial infarction Frontiers in Cardiovascular Medicine myocardial infarction ventricular tachycardia electrophysiology study standard modifiable risk factors LVEF (left ventricular ejection fraction) |
| title | Influence of standard modifiable risk factors on ventricular tachycardia after myocardial infarction |
| title_full | Influence of standard modifiable risk factors on ventricular tachycardia after myocardial infarction |
| title_fullStr | Influence of standard modifiable risk factors on ventricular tachycardia after myocardial infarction |
| title_full_unstemmed | Influence of standard modifiable risk factors on ventricular tachycardia after myocardial infarction |
| title_short | Influence of standard modifiable risk factors on ventricular tachycardia after myocardial infarction |
| title_sort | influence of standard modifiable risk factors on ventricular tachycardia after myocardial infarction |
| topic | myocardial infarction ventricular tachycardia electrophysiology study standard modifiable risk factors LVEF (left ventricular ejection fraction) |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1283382/full |
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