Abstract:
Objectives: To evaluate clinical characteristics and prognosis of
patients presented with ventricular tachyarrhythmia (VTA) during the
course of acute coronary syndrome (ACS) and to analyze it according to
period of presentation.
Background: VTA is an infrequent yet serious complication of ACS. There
is limited data regarding the incidence and prognostic implications of
VTA in the last decade as compared with the previous decade.
Methods: We evaluated clinical characteristics, major adverse
cardiovascular events, short and long- term mortality of patients
hospitalized with ACS who were enrolled in the Acute Coronary Syndrome
Israeli Survey (ACSIS) during the years 2000-2016. Patients were
classified into three groups: no VTA, early VTA (≤48h of onset) and late
VTA (>48h of onset). Data were analyzed according to
decades of presentation (current decade vs. previous decade).
Results: The study population comprised 15,200 patients. VTA
occurred in 487 (3.2%) of patients. Early VTA presented in 373/487
(77%) patients and late VTA in 114/487 (23%) patients. VTA’s,
occurring in ACS patients were associated with increased risk of
in-hospital, 30-days, 1-year and 5-year mortality rates during both
early and late periods in compared with no VTA. Moreover, late VTA was
associated with the highest mortality rate with up to 65% in 5-year
follow up (p<0.001). Nevertheless, late VTA was associated
with lower mortality rate in the current decade (2008-2016) compared
with last decade (2000-2006).
Conclusions: Any VTA following ACS was associated with high short and
long-term mortality rate. However, over the past decade there has been a
significant improvement in survival rates, especially in patients with
late VTA. This may be attributed to early and invasive reperfusion
therapy, implantable cardioverter defibrillator implantation and better
medical treatment.
Key words: Ventricular tachyarrhythmia, all-cause mortality, acute
coronary syndrome, NSTEMI, STEMI, risk-factors.
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