4.4 Article

Prognostic implications of early monomorphic and non-monomorphic tachyarrhythmias in patients discharged with acute coronary syndrome

Journal

HEART RHYTHM
Volume 15, Issue 6, Pages 822-829

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.hrthm.2018.02.016

Keywords

Acute coronary syndrome; Monomorphic ventricular tachycardia; Mortality; Polymorphic ventricular tachycardia; Ventricular fibrillation

Funding

  1. Sun Chieh Yeh Heart Foundation

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BACKGROUND The prognostic implication of early ventricular tachyarrhythmias (VTs) after acute coronary syndrome (ACS) remains unclear. OBJECTIVE We sought to investigate the clinical outcomes of early monomorphic and non-monomorphic VTs that occur within 48 hours in patients after ACS. METHODS We retrospectively reviewed the clinical outcomes of 2033 [mean age 67.0 +/- 13.4 years; 1486 (73.1%) men] consecutive patients who presented with ACS from 2004 to 2015. < p > RESULTS A total of 67 (3.3%) and 90 (4.4%) patients developed early monomorphic or non-monomorphic VT, respectively. Killip class IV (odds ratio [OR] 3.05; 95% confidence interval [CI] 1.476.36; P < .01), creatine kinase level (OR 1.01; 95% Cl 1.00-1.02 per 100 IU/L; P = .01), and left ventricular ejection fraction (OR 0.96; 95% Cl 0.94-0.99; P < .01) were independently associated with early monomorphic VT, whereas age (OR 0.98; 95% CI 0.97-0.99; P = .04), ST elevated myocardial infarction (OR 3.53; 95% CI 1.71-7.27; P < .01), Killip class IV (OR 4.91; 95% CI 2.76-8.74; P < .01), diabetes mellitus (OR 0.48; 95% CI 0.28-0.81; P < .01), and left ventricular ejection fraction (OR CONCLUSION Early monomorphic VT, but not early non-monomorphic VT, independently predicted all-cause mortality in patients with ACS who survived to hospital discharge.

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