A new risk score for ventricular tachyarrhythmia in acute myocardial infarction with preserved left ventricular ejection fraction
- Affiliated Author(s)
- 허승호
- Alternative Author(s)
- Hur, Seung Ho
- Journal Title
- Journal of Cardiology
- ISSN
- 1876-4738
- Issued Date
- 2018
- Keyword
- Ventricular tachycardia; Ventricular fibrillation; Myocardial infarction; Prognosis
- Abstract
- Background:
Ventricular tachycardia or fibrillation (VT/VF) is a major cause of sudden cardiac death after acutemyocardial infarction (AMI). This study aims to investigate the clinical characteristics and outcomes of VT/VF, to identify the variables associated with VT/VF, and to construct a new scoring system.
Methods:
Patients with relatively preserved left ventricular ejection fraction (LVEF) ( 40%) included in the Korea Acute Myocardial Infarction Registry-National Institutes of Health registrywere enrolled in this study. Among 13,109 patients in the registry, a total of 10,334 (78.8%) had relatively preserved LVEF after AMI. Patients were divided into two groups based on whether they experienced life-threatening VT/VF during hospitalization or not. The predictors for VT/VF during hospitalizationwere assessed. In-hospital mortality and complications were recorded.
Results:
A total of 358 (3.5%) experienced life-threatening VT/VF. The VT/VF group was at an increased risk of in-hospital mortality (odds ratio 2.99) and cardiac death (odds ratio 3.40). Variables of diagnosis, Killip class, smoking, initial rhythm, left bundle branch block, and LVEF were significant indicators of VT/ VF. A new risk score system yielded acceptable discrimination function (c-statistics = 0.773).
Conclusions:
Relatively preserved LVEF patients could still be at risk of life-threatening VT/VF, which is related to a poor prognosis during the admission period. This new scoring system can be adopted to stratify the risk of VT/VF.
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