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 retr...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-10-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.118.010004 |
| _version_ | 1819178957743849472 |
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| author | Michael Behnes Kambis Mashayekhi Christel Weiß Christoph Nienaber Siegfried Lang Linda Reiser Armin Bollow Gabriel Taton Thomas Reichelt Dominik Ellguth Niko Engelke Tobias Schupp Uzair Ansari Ibrahim El‐Battrawy Jonas Rusnak Muharrem Akin Martin Borggrefe Ibrahim Akin |
| author_facet | Michael Behnes Kambis Mashayekhi Christel Weiß Christoph Nienaber Siegfried Lang Linda Reiser Armin Bollow Gabriel Taton Thomas Reichelt Dominik Ellguth Niko Engelke Tobias Schupp Uzair Ansari Ibrahim El‐Battrawy Jonas Rusnak Muharrem Akin Martin Borggrefe Ibrahim Akin |
| author_sort | Michael Behnes |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-22T21:50:48Z |
| format | Article |
| id | doaj.art-313d3de2ffae4f0a86c2235c23ae3be0 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-22T21:50:48Z |
| publishDate | 2018-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-313d3de2ffae4f0a86c2235c23ae3be02022-12-21T18:11:22ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-10-0171910.1161/JAHA.118.010004Prognostic Impact of Acute Myocardial Infarction in Patients Presenting With Ventricular Tachyarrhythmias and Aborted Cardiac ArrestMichael Behnes0Kambis Mashayekhi1Christel Weiß2Christoph Nienaber3Siegfried Lang4Linda Reiser5Armin Bollow6Gabriel Taton7Thomas Reichelt8Dominik Ellguth9Niko Engelke10Tobias Schupp11Uzair Ansari12Ibrahim El‐Battrawy13Jonas Rusnak14Muharrem Akin15Martin Borggrefe16Ibrahim Akin17First Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyDepartment of Cardiology and Angiology II University Heart Center Freiburg Bad Krozingen Bad Krozingen GermanyInstitute of Biomathematics and Medical Statistics Faculty of Medicine Mannheim University Medical Center Mannheim (UMM) Heidelberg University Mannheim GermanyRoyal Brompton and Harefield Hospitals NHS London United KingdomFirst Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyFirst Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyFirst Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyFirst Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyFirst Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyFirst Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyFirst Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyFirst Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyFirst Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyFirst Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyFirst Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyDepartment of Cardiology and Angiology Hannover Medical School Hannover GermanyFirst Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyFirst Department of Medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg European Center for AngioScience (ECAS) Mannheim GermanyBackground 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.https://www.ahajournals.org/doi/10.1161/JAHA.118.010004myocardial infarctionnon ST‐segment elevation acute coronary syndromeST‐segment elevation myocardial infarctionsudden cardiac arrestventricular tachyarrhythmia |
| spellingShingle | Michael Behnes Kambis Mashayekhi Christel Weiß Christoph Nienaber Siegfried Lang Linda Reiser Armin Bollow Gabriel Taton Thomas Reichelt Dominik Ellguth Niko Engelke Tobias Schupp Uzair Ansari Ibrahim El‐Battrawy Jonas Rusnak Muharrem Akin Martin Borggrefe Ibrahim Akin Prognostic Impact of Acute Myocardial Infarction in Patients Presenting With Ventricular Tachyarrhythmias and Aborted Cardiac Arrest Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease myocardial infarction non ST‐segment elevation acute coronary syndrome ST‐segment elevation myocardial infarction sudden cardiac arrest ventricular tachyarrhythmia |
| 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 | myocardial infarction non ST‐segment elevation acute coronary syndrome ST‐segment elevation myocardial infarction sudden cardiac arrest ventricular tachyarrhythmia |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.118.010004 |
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