Prognostic significance of ventricular arrhythmias in 13 444 patients with acute coronary syndrome: A retrospective cohort study based on routine clinical data (NIHR Health Informatics Collaborative VA-ACS Study)
<strong>Background</strong> A minority of acute coronary syndrome (ACS) cases are associated with ventricular arrhythmias (VA) and/or cardiac arrest (CA). We investigated the effect of VA/CA at the time of ACS on long‐term outcomes. <br> <strong>Methods and Results</strong...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
American Heart Association
2022
|
| _version_ | 1797107531548459008 |
|---|---|
| author | Sau, A Kaura, A Ahmed, A Patel, KHK Li, X Mulla, A Glampson, B Panoulas, V Davies, J Woods, K Gautama, S Shah, AD Elliott, P Hemingway, H Williams, B Asselbergs, FW Melikian, N Peters, NS Shah, AM Perera, D Kharbanda, R Patel, RS Channon, KM Mayet, J Ng, FS |
| author_facet | Sau, A Kaura, A Ahmed, A Patel, KHK Li, X Mulla, A Glampson, B Panoulas, V Davies, J Woods, K Gautama, S Shah, AD Elliott, P Hemingway, H Williams, B Asselbergs, FW Melikian, N Peters, NS Shah, AM Perera, D Kharbanda, R Patel, RS Channon, KM Mayet, J Ng, FS |
| author_sort | Sau, A |
| collection | OXFORD |
| description | <strong>Background</strong>
A minority of acute coronary syndrome (ACS) cases are associated with ventricular arrhythmias (VA) and/or cardiac arrest (CA). We investigated the effect of VA/CA at the time of ACS on long‐term outcomes.
<br>
<strong>Methods and Results</strong>
We analyzed routine clinical data from 5 National Health Service trusts in the United Kingdom, collected between 2010 and 2017 by the National Institute for Health Research Health Informatics Collaborative. A total of 13 444 patients with ACS, 376 (2.8%) of whom had concurrent VA, survived to hospital discharge and were followed up for a median of 3.42 years. Patients with VA or CA at index presentation had significantly increased risks of subsequent VA during follow‐up (VA group: adjusted hazard ratio [HR], 4.15 [95% CI, 2.42–7.09]; CA group: adjusted HR, 2.60 [95% CI, 1.23–5.48]). Patients who suffered a CA in the context of ACS and survived to discharge also had a 36% increase in long‐term mortality (adjusted HR, 1.36 [95% CI, 1.04–1.78]), although the concurrent diagnosis of VA alone during ACS did not affect all‐cause mortality (adjusted HR, 1.03 [95% CI, 0.80–1.33]).
<br>
<strong>Conclusions</strong>
Patients who develop VA or CA during ACS who survive to discharge have increased risks of subsequent VA, whereas those who have CA during ACS also have an increase in long‐term mortality. These individuals may represent a subgroup at greater risk of subsequent arrhythmic events as a result of intrinsically lower thresholds for developing VA. |
| first_indexed | 2024-03-07T07:16:00Z |
| format | Journal article |
| id | oxford-uuid:ddebb256-5379-4b90-b432-b5c3ee3b97ef |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:16:00Z |
| publishDate | 2022 |
| publisher | American Heart Association |
| record_format | dspace |
| spelling | oxford-uuid:ddebb256-5379-4b90-b432-b5c3ee3b97ef2022-08-09T16:42:55ZPrognostic significance of ventricular arrhythmias in 13 444 patients with acute coronary syndrome: A retrospective cohort study based on routine clinical data (NIHR Health Informatics Collaborative VA-ACS Study)Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ddebb256-5379-4b90-b432-b5c3ee3b97efEnglishSymplectic ElementsAmerican Heart Association2022Sau, AKaura, AAhmed, APatel, KHKLi, XMulla, AGlampson, BPanoulas, VDavies, JWoods, KGautama, SShah, ADElliott, PHemingway, HWilliams, BAsselbergs, FWMelikian, NPeters, NSShah, AMPerera, DKharbanda, RPatel, RSChannon, KMMayet, JNg, FS<strong>Background</strong> A minority of acute coronary syndrome (ACS) cases are associated with ventricular arrhythmias (VA) and/or cardiac arrest (CA). We investigated the effect of VA/CA at the time of ACS on long‐term outcomes. <br> <strong>Methods and Results</strong> We analyzed routine clinical data from 5 National Health Service trusts in the United Kingdom, collected between 2010 and 2017 by the National Institute for Health Research Health Informatics Collaborative. A total of 13 444 patients with ACS, 376 (2.8%) of whom had concurrent VA, survived to hospital discharge and were followed up for a median of 3.42 years. Patients with VA or CA at index presentation had significantly increased risks of subsequent VA during follow‐up (VA group: adjusted hazard ratio [HR], 4.15 [95% CI, 2.42–7.09]; CA group: adjusted HR, 2.60 [95% CI, 1.23–5.48]). Patients who suffered a CA in the context of ACS and survived to discharge also had a 36% increase in long‐term mortality (adjusted HR, 1.36 [95% CI, 1.04–1.78]), although the concurrent diagnosis of VA alone during ACS did not affect all‐cause mortality (adjusted HR, 1.03 [95% CI, 0.80–1.33]). <br> <strong>Conclusions</strong> Patients who develop VA or CA during ACS who survive to discharge have increased risks of subsequent VA, whereas those who have CA during ACS also have an increase in long‐term mortality. These individuals may represent a subgroup at greater risk of subsequent arrhythmic events as a result of intrinsically lower thresholds for developing VA. |
| spellingShingle | Sau, A Kaura, A Ahmed, A Patel, KHK Li, X Mulla, A Glampson, B Panoulas, V Davies, J Woods, K Gautama, S Shah, AD Elliott, P Hemingway, H Williams, B Asselbergs, FW Melikian, N Peters, NS Shah, AM Perera, D Kharbanda, R Patel, RS Channon, KM Mayet, J Ng, FS Prognostic significance of ventricular arrhythmias in 13 444 patients with acute coronary syndrome: A retrospective cohort study based on routine clinical data (NIHR Health Informatics Collaborative VA-ACS Study) |
| title | Prognostic significance of ventricular arrhythmias in 13 444 patients with acute coronary syndrome: A retrospective cohort study based on routine clinical data (NIHR Health Informatics Collaborative VA-ACS Study) |
| title_full | Prognostic significance of ventricular arrhythmias in 13 444 patients with acute coronary syndrome: A retrospective cohort study based on routine clinical data (NIHR Health Informatics Collaborative VA-ACS Study) |
| title_fullStr | Prognostic significance of ventricular arrhythmias in 13 444 patients with acute coronary syndrome: A retrospective cohort study based on routine clinical data (NIHR Health Informatics Collaborative VA-ACS Study) |
| title_full_unstemmed | Prognostic significance of ventricular arrhythmias in 13 444 patients with acute coronary syndrome: A retrospective cohort study based on routine clinical data (NIHR Health Informatics Collaborative VA-ACS Study) |
| title_short | Prognostic significance of ventricular arrhythmias in 13 444 patients with acute coronary syndrome: A retrospective cohort study based on routine clinical data (NIHR Health Informatics Collaborative VA-ACS Study) |
| title_sort | prognostic significance of ventricular arrhythmias in 13 444 patients with acute coronary syndrome a retrospective cohort study based on routine clinical data nihr health informatics collaborative va acs study |
| work_keys_str_mv | AT saua prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT kauraa prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT ahmeda prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT patelkhk prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT lix prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT mullaa prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT glampsonb prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT panoulasv prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT daviesj prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT woodsk prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT gautamas prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT shahad prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT elliottp prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT hemingwayh prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT williamsb prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT asselbergsfw prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT melikiann prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT petersns prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT shaham prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT pererad prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT kharbandar prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT patelrs prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT channonkm prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT mayetj prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy AT ngfs prognosticsignificanceofventriculararrhythmiasin13444patientswithacutecoronarysyndromearetrospectivecohortstudybasedonroutineclinicaldatanihrhealthinformaticscollaborativevaacsstudy |