Author + information
- Bryan Har,
- George Veenhuyzen,
- Diane Galbraith,
- Danielle Southern,
- Stephen Wilton and
- Merril Knudtson
Background: ST-Elevation Myocardial Infarction (STEMI) may be complicated by ventricular tachycardia (VT) and/or ventricular fibrillation (VF). We assessed the relationship between VT/VF requiring electrical therapy at the time of primary percutaneous coronary intervention (PCI) for STEMI and death during early and late follow-up.
Methods: We included a prospective cohort of 3814 patients undergoing primary PCI for STEMI from 2002-2012. We excluded patients who received fibrinolysis prior to PCI. Median follow-up time was 5.3 years. Our primary outcome was death during follow-up. We performed a landmark analysis for death more than 30-days after STEMI presentation.
Results: 158 of 3814 patients had VT and/or VF requiring electrical cardioversion and/or defibrillation during primary PCI. A greater proportion of patients with VT/VF during primary PCI died on the day of presentation (12.0% versus 0.52%), at 30 days (24.1% versus 3.6%), and during follow-up (38.6% versus 14.6%). After adjustment for heart failure, VT/VF during primary PCI was associated with death during follow-up (adjusted HR 2.14, 95%CI 1.56-2.94). Among subjects that survived beyond 30-days, VT/VF during primary PCI was not associated with death (adjusted HR 1.45, 95%CI 0.93-2.25).
Conclusions: Serious ventricular arrhythmias during primary PCI for STEMI are associated with early, but not late mortality. This higher-risk population may benefit from additional early post-MI monitoring and interventions.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes, Diagnosis, Management and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1253-343
- 2017 American College of Cardiology Foundation