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• W2786907965 abstract "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. 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] 1.47–6.36; P < .01), creatine kinase level (OR 1.01; 95% CI 1.00–1.02 per 100 IU/L; P = .01), and left ventricular ejection fraction (OR 0.96; 95% CI 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 0.97; 95% CI 0.95–0.99; P < .01) were independently associated with early non–monomorphic VT. More patients with early monomorphic VT (n = 22 [32.8%]) died in hospital than those with non–monomorphic VT (n = 16 [17.8%]) or without early VT (n = 133 [7.1%]; P < .01). After a mean follow-up of 67.8 ± 43.2 months, 21 patients with early monomorphic VT (46.7%), 22 patients with early non–monomorphic VT (29.7%), and 552 patients without early VT (31.7%) died. Both early monomorphic and non–monomorphic VTs were associated with a long-term increase in sudden arrhythmic deaths and recurrent VTs. Nevertheless, only early monomorphic VT was shown to independently predict overall survival (hazard ratio 1.62; 95% CI 1.03–2.55; P = .04). Conclusion Early monomorphic VT, but not early non–monomorphic VT, independently predicted all-cause mortality in patients with ACS who survived to hospital discharge. The prognostic implication of early ventricular tachyarrhythmias (VTs) after acute coronary syndrome (ACS) remains unclear. We sought to investigate the clinical outcomes of early monomorphic and non–monomorphic VTs that occur within 48 hours in patients after ACS. 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. 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] 1.47–6.36; P < .01), creatine kinase level (OR 1.01; 95% CI 1.00–1.02 per 100 IU/L; P = .01), and left ventricular ejection fraction (OR 0.96; 95% CI 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 0.97; 95% CI 0.95–0.99; P < .01) were independently associated with early non–monomorphic VT. More patients with early monomorphic VT (n = 22 [32.8%]) died in hospital than those with non–monomorphic VT (n = 16 [17.8%]) or without early VT (n = 133 [7.1%]; P < .01). After a mean follow-up of 67.8 ± 43.2 months, 21 patients with early monomorphic VT (46.7%), 22 patients with early non–monomorphic VT (29.7%), and 552 patients without early VT (31.7%) died. Both early monomorphic and non–monomorphic VTs were associated with a long-term increase in sudden arrhythmic deaths and recurrent VTs. Nevertheless, only early monomorphic VT was shown to independently predict overall survival (hazard ratio 1.62; 95% CI 1.03–2.55; P = .04). Early monomorphic VT, but not early non–monomorphic VT, independently predicted all-cause mortality in patients with ACS who survived to hospital discharge." @default.
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• W2786907965 date "2018-06-01" @default.
• W2786907965 modified "2023-10-01" @default.
• W2786907965 title "Prognostic implications of early monomorphic and non–monomorphic tachyarrhythmias in patients discharged with acute coronary syndrome" @default.
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• W2786907965 doi "https://doi.org/10.1016/j.hrthm.2018.02.016" @default.
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