Incidence and predictors of sudden arrhythmic death or ventricular tachyarrhythmias after acute coronary syndrome: An asian perspective

详细信息    查看全文

• 作者：Jo-Jo Hai ; MBBS^* ; ^&dagger ; ; Edward Tam ; MBBS^* ; Pak-Hei Chan ; MBBS^* ; ^&Dagger ; ; Chu-Pak Lau ; MD ; FHRS^* ; Chung-Wah Siu ; MD^* ; ^&dagger ; ; Hung-Fat Tse ; MD ; PhD^* ; ^§ ; ; ^&dagger ; ; ^&Dagger ; ; ^hftse@hku.hk
• 关键词：Asian ; Acute coronary syndrome ; Sudden arrhythmic death ; Ventricular tachycardia ; Ventricular fibrillation
• 刊名：Heart Rhythm
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：14
• 期：1
• 页码：81-87
• 全文大小：746 K
• 卷排序：14

文摘

Current data on the risk of sudden arrhythmic death (SAD) and ventricular tachyarrhythmias (VTs) after acute coronary syndrome (ACS) in the Asian population are limited.ObjectiveThe purpose of this study was to investigate the incidence and predictors of SAD or VT after ACS in a contemporary cohort of Chinese patients in the era of early revascularization.MethodsConsecutive patients admitted to our unit for ACS from 2010 to 2015 were retrospectively reviewed.ResultsA total of 918 patients (74.8% male, mean age 65.9 ± 13.4 years) were included in the study. Of these patients, 864 (94.1%) survived to discharge. After a mean of 34.1 ± 21.8 months, 42 (4.9%) had SAD or VT. The event rate was 0.46% in month 1, 0.26% per month in the months 2 to 6, 0.15% per month in months 6 to 12, and 1.23% per year from the second year onward. In multivariate analysis, early VT (hazard ratio [HR] 5.78, 95% confidence interval [CI] 2.63–12.72, P < .01), left ventricular ejection fraction ≤35% (HR 1.96, 95% CI 1.03–3.73, P = .04), prior coronary artery disease (HR 2.50, 95% CI 1.29–4.82, P < .01), triple-vessel disease (HR 3.69, 95% CI 1.81–7.54, P < .01), and chronic kidney disease (HR 2.43, 95% CI 1.21–4.92, P = .01) independently predicted SAD or VT.ConclusionThis study reports the rate of SAD or VT among Asian patients after ACS in the era of early revascularization and optimal medical therapy. Aggressive preventive measures should be considered for patients with multiple risk factors for SAD or VT, especially in the initial period after ACS.