کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5930010 | 1572118 | 2016 | 5 صفحه PDF | دانلود رایگان |

- Presenting characteristics and long-term outcomes of patients with early ventricular arrhythmias after acute myocardial infarction (MI) are analyzed in this study.
- Patients with early ventricular arrhythmias were more likely to have ST-segment elevation (vs non-ST-segment elevation myocardial infarction), lower left ventricular ejection fraction, and more frequently presented in cardiogenic shock.
- In the era of primary revascularization for acute MI, the presence of early ventricular arrhythmia after MI does not portend a worse long-term prognosis in those who survive to hospital discharge.
Guidelines do not recommend an implantable cardioverter defibrillator (ICD) for prevention of sudden death in patients who develop ventricular arrhythmia (VA) within 48 hours of acute myocardial infarction (AMI) if they are successfully revascularized. We aimed to determine long-term survival in a cohort of early VA survivors treated with percutaneous coronary intervention (PCI) and to determine whether certain high-risk characteristics predicted worse outcomes. This retrospective study included all patients with early VA after AMI treated with PCI at our institution from 2002 to 2012 who survived to hospital discharge. Patients who had an ICD before their index AMI and those who received ICD before hospital discharge were excluded. Overall survival in the early VA survivors was analyzed based on post-MI left ventricular ejection fraction (LVEF) (â¥50% vs <50%), MI type (ST-segment elevation myocardial infarction [STEMI] vs non-ST-segment elevation myocardial infarction [NSTEMI]), and single-vessel versus multivessel disease. Baseline presenting clinical and PCI characteristics plus outcomes were compared with matched controls with PCI-treated AMI but no early VA. Of the 79 early VA survivors treated with PCI, there were no significant differences in long-term overall survival between AMI type (STEMI vs NSTEMI), single-vessel versus multivessel disease, and LVEF at time of MI (>50% vs <50%). Despite having lower presenting LVEF (46% vs 55%, p <0.001) and higher rates of cardiogenic shock (28% vs 4%; p <0.001), survivors of early VA had similar overall survival compared with PCI-treated controls whose post-AMI hospital course was not complicated by early VA (p = 0.61). In conclusion, patients with early VA treated with PCI who survive to discharge were more likely to have STEMI, lower LVEF, and cardiogenic shock. Type of AMI or the presence of systolic dysfunction or multivessel disease did not predict long-term mortality. With early PCI, early VA survivors have similar long-term prognosis compared with those without early VA.
Journal: The American Journal of Cardiology - Volume 117, Issue 5, 1 March 2016, Pages 709-713