Clinical Impact of Ventricular Tachycardia and/or Fibrillation During the Acute Phase of Acute Myocardial Infarction on In-Hospital and 5-Year Mortality Rates in the Percutaneous Coronary Intervention Era

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  • Masuda Masaharu
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine Cardiovascular Center, Kansai Rosai Hospital
  • Nakatani Daisaku
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Hikoso Shungo
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Suna Shinichiro
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Usami Masaya
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Matsumoto Sen
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Kitamura Tetsuhisa
    Department of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine
  • Minamiguchi Hitoshi
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Okuyama Yuji
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Uematsu Masaaki
    Cardiovascular Center, Kansai Rosai Hospital
  • Yamada Takahisa
    Department of Cardiology, Osaka General Medical Center
  • Iwakura Katsuomi
    Cardiovascular Center, Sakurabashi Watanabe Hospital
  • Hamasaki Toshimitsu
    Office of Biostatistics and Data Management, National Cerebral and Cardiovascular Center
  • Sakata Yasuhiko
    Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
  • Sato Hiroshi
    School of Human Welfare Studies Health Care Center and Clinic Kwansei Gakuin
  • Nanto Shinsuke
    Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine
  • Hori Masatsugu
    Osaka Prefectural Hospital Organization, Osaka Medical Center for Cancer and Cardiovascular Disease
  • Komuro Issei
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine Department of Cardiovascular Medicine, The University of Tokyo Graduate School of Medicine
  • Sakata Yasushi
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • on behalf of the OACIS investigators

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Background:The aim of this study was to investigate the prognostic impact of acute-phase ventricular tachycardia and fibrillation (VT/VF) on ST-segment elevation myocardial infarction (STEMI) patients in the percutaneous coronary intervention (PCI) era.Methods and Results:Using the database of the Osaka Acute Coronary Insufficiency Study (OACIS), we studied 4,283 consecutive patients with STEMI who were hospitalized within 12 h of STEMI onset and underwent emergency PCI. Acute-phase VT/VF, defined as ≥3 consecutive ventricular premature complexes and/or VF within the 1st week of hospitalization, occurred in 997 (23.3%) patients. In-hospital mortality risk was significantly higher in patients with acute-phase VT/VF than inthose without (14.6% vs. 4.3%, adjusted hazard ratio (HR) 1.83, P=0.0013). Among patients discharged alive, 5-year mortality rates were comparable between patients with and without acute-phase VT/VF. Subgroup analysis showed that acute-phase VT/VF was associated with increased 5-year mortality after discharge in high-risk patients (GRACE Risk Score ≥115; adjusted HR 1.60, P=0.043), but not in intermediate- or low-risk patients.Conclusions:Even in the PCI era, acute-phase VT/VF was associated with higher in-hospital deaths of STEMI patients. However, the 5-year prognostic impact of acute-phase VT/VF was limited to high-risk patients. (Circ J 2016; 80: 1539–1547)

Journal

  • Circulation Journal

    Circulation Journal 80 (7), 1539-1547, 2016

    The Japanese Circulation Society

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