Factors Associated With and Outcomes After Ventricular Fibrillation Before and During Primary Angioplasty in Patients With ST-Segment Elevation Myocardial Infarction

We aimed to assess the risk factors and outcome of ventricular fibrillation (VF) before and during primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction. From 1999 to 2012, we consecutively enrolled 5,373 patients with ST-segment elevation myoc...

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Bibliographic Details
Published in:The American journal of cardiology 2015-09, Vol.116 (5), p.678-685
Main Authors: Jabbari, Reza, MD, PhD, Risgaard, Bjarke, MD, PhD, Fosbøl, Emil L., MD, PhD, Scheike, Thomas, PhD, Philbert, Berit T., MD, PhD, Winkel, Bo G., MD, PhD, Albert, Christine M., MD, MPH, Glinge, Charlotte, MD, Ahtarovski, Kiril A., MD, PhD, Haunsø, Stig, MD, DMSci, Køber, Lars, MD, DMSci, Jørgensen, Erik, MD, Pedersen, Frants, MD, PhD, Tfelt-Hansen, Jacob, MD, DMSci, Engstrøm, Thomas, MD, PhD, DMSci
Format: Article
Language:English
Subjects:
Aged
Angina pectoris
Angioplasty
Angioplasty, Balloon, Coronary
Cardiovascular
Cause of Death - trends
Denmark - epidemiology
Electrocardiography
Female
Follow-Up Studies
Heart attacks
Humans
Intraoperative Period
Male
Middle Aged
Mortality
Myocardial Infarction - complications
Myocardial Infarction - diagnosis
Myocardial Infarction - surgery
Preoperative Period
Prognosis
Retrospective Studies
Survival Rate - trends
Time Factors
Treatment Outcome
Ventricular Fibrillation - etiology
Ventricular Fibrillation - mortality
Ventricular Fibrillation - physiopathology
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Summary:We aimed to assess the risk factors and outcome of ventricular fibrillation (VF) before and during primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction. From 1999 to 2012, we consecutively enrolled 5,373 patients with ST-segment elevation myocardial infarction. In total, 410 of the patients had VF before and 88 had VF during PPCI. During a mean follow-up of 4.2 years, 1,196 subjects died. A logistic regression model identified younger age, anterior infarct, Killip class >I at admission, and a preprocedural Thrombolysis In Myocardial Infarction flow grade of 0 to I to be significantly associated with VF before PPCI, whereas inferior infarct, a preprocedural Thrombolysis In Myocardial Infarction flow grade of 0 to I, and Killip class >I at admission were significantly associated with VF during PPCI. All-cause mortality was evaluated using the Cox regression model. Compared with the patients without VF, those with VF before or during PPCI had a significantly increased 30-day mortality, with an adjusted hazard ratio = 3.40 (95% confidence interval 1.70 to 6.70) and 4.20 (95% confidence interval 1.30 to 13.30), respectively. Importantly, there was no tendency of 30-day mortality difference between VF before and during PPCI (p = 0.170). In patients with VF before or during PPCI who survived for at least 30 days, there was no increase in the long-term mortality. In conclusion, our data suggest that 30-day mortality is the same for patients with VF before PPCI compared with VF during PPCI, and the occurrence of VF before or during PPCI was associated with increased 30-day mortality but not with long-term mortality.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2015.05.037