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Prognostic Significance of Postprocedural Sustained Ventricular Tachycardia or Fibrillation in Patients Undergoing Primary Percutaneous Coronary Intervention (from the HORIZONS-AMI Trial)

The prognostic significance of postprocedure sustained ventricular tachycardia or ventricular fibrillation (VT/VF) in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) has rarely been studied, although a previous study has su... Full description

Journal Title: The American journal of cardiology 2012, Vol.109 (6), p.805-812
Main Author: Mehta, Rajendra H., MD, MS
Other Authors: Yu, Jennifer, MBBS , Piccini, Jonathan P., MD , Tcheng, James E., MD , Farkouh, Michael E., MD , Reiffel, James, MD , Fahy, Martin, MSc , Mehran, Roxana, MD , Stone, Gregg W., MD
Format: Electronic Article Electronic Article
Language: English
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Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0002-9149
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recordid: cdi_proquest_miscellaneous_926509214
title: Prognostic Significance of Postprocedural Sustained Ventricular Tachycardia or Fibrillation in Patients Undergoing Primary Percutaneous Coronary Intervention (from the HORIZONS-AMI Trial)
format: Article
creator:
  • Mehta, Rajendra H., MD, MS
  • Yu, Jennifer, MBBS
  • Piccini, Jonathan P., MD
  • Tcheng, James E., MD
  • Farkouh, Michael E., MD
  • Reiffel, James, MD
  • Fahy, Martin, MSc
  • Mehran, Roxana, MD
  • Stone, Gregg W., MD
subjects:
  • Abnormalities
  • Abridged Index Medicus
  • ACE inhibitors
  • Adrenergic beta blockers
  • Aged
  • Angioplasty, Balloon, Coronary - adverse effects
  • Angiotensin
  • Biological and medical sciences
  • Cardiac arrhythmia
  • Cardiac dysrhythmias
  • Cardiac patients
  • Cardiology. Vascular system
  • Cardiovascular
  • Clinical trials
  • Diabetes
  • Diseases of the cardiovascular system
  • Electrocardiography
  • Enzyme inhibitors
  • Enzymes
  • Female
  • Follow-Up Studies
  • Heart
  • Heart attacks
  • Humans
  • Hypertension
  • Incidence
  • Male
  • Medical sciences
  • Middle Aged
  • Mortality
  • Muscle contraction
  • Myocardial Infarction - physiopathology
  • Myocardial Infarction - therapy
  • Prognosis
  • Prospective Studies
  • Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
  • Risk Factors
  • Tachycardia
  • Tachycardia, Ventricular - epidemiology
  • Tachycardia, Ventricular - etiology
  • Tachycardia, Ventricular - physiopathology
  • Time Factors
  • Transluminal angioplasty
  • United States - epidemiology
  • Ventricular Fibrillation - epidemiology
  • Ventricular Fibrillation - etiology
  • Ventricular Fibrillation - physiopathology
  • Ventricular tachycardia
ispartof: The American journal of cardiology, 2012, Vol.109 (6), p.805-812
description: The prognostic significance of postprocedure sustained ventricular tachycardia or ventricular fibrillation (VT/VF) in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) has rarely been studied, although a previous study has suggested that its occurrence portends decreased survival. We examined outcomes from the prospective large-scale multicenter randomized HORIZONS-AMI trial to evaluate the incidence, clinical correlates, and outcomes of in-hospital sustained VT/VF after PPCI. Of 3,485 patients undergoing PPCI in whom VT/VF did not occur before or during the procedure, 181 patients (5.2%) developed VT/VF after PPCI. Most postprocedural VT/VF episodes (85%) occurred in the first 48 hours. Patients with postprocedural VT/VF were more likely men with Killip class >I on presentation but had a lower prevalence of hypertension and diabetes. Patients with postprocedural VT/VF were also less frequently taking β blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers at admission. Mean door-to-balloon time was shorter and Thrombolysis In Myocardial Infarction grade 0 flow before PPCI was more common in patients with VT/VF, although Thrombolysis In Myocardial Infarction grade 3 flow rates after PPCI did not vary. There were no significant differences in adjusted 3-year rates of mortality (hazard ratio 0.73, 95% confidence interval 0.30 to 1.79) or composite major adverse clinical events (death, myocardial infarction, target vessel revascularization, or stroke; hazard ratio 0.71, 95% confidence interval 0.44 to 1.15) in patients with versus without postprocedural sustained VT/VF. In conclusion, sustained VT/VF after PPCI in the HORIZONS-AMI trial was not significantly associated with 3-year mortality or major adverse clinical events. Further studies are required to address the prognostic significance of VT/VF in patients with STEMI undergoing PPCI.
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titlePrognostic Significance of Postprocedural Sustained Ventricular Tachycardia or Fibrillation in Patients Undergoing Primary Percutaneous Coronary Intervention (from the HORIZONS-AMI Trial)
creatorMehta, Rajendra H., MD, MS ; Yu, Jennifer, MBBS ; Piccini, Jonathan P., MD ; Tcheng, James E., MD ; Farkouh, Michael E., MD ; Reiffel, James, MD ; Fahy, Martin, MSc ; Mehran, Roxana, MD ; Stone, Gregg W., MD
creatorcontribMehta, Rajendra H., MD, MS ; Yu, Jennifer, MBBS ; Piccini, Jonathan P., MD ; Tcheng, James E., MD ; Farkouh, Michael E., MD ; Reiffel, James, MD ; Fahy, Martin, MSc ; Mehran, Roxana, MD ; Stone, Gregg W., MD
descriptionThe prognostic significance of postprocedure sustained ventricular tachycardia or ventricular fibrillation (VT/VF) in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) has rarely been studied, although a previous study has suggested that its occurrence portends decreased survival. We examined outcomes from the prospective large-scale multicenter randomized HORIZONS-AMI trial to evaluate the incidence, clinical correlates, and outcomes of in-hospital sustained VT/VF after PPCI. Of 3,485 patients undergoing PPCI in whom VT/VF did not occur before or during the procedure, 181 patients (5.2%) developed VT/VF after PPCI. Most postprocedural VT/VF episodes (85%) occurred in the first 48 hours. Patients with postprocedural VT/VF were more likely men with Killip class >I on presentation but had a lower prevalence of hypertension and diabetes. Patients with postprocedural VT/VF were also less frequently taking β blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers at admission. Mean door-to-balloon time was shorter and Thrombolysis In Myocardial Infarction grade 0 flow before PPCI was more common in patients with VT/VF, although Thrombolysis In Myocardial Infarction grade 3 flow rates after PPCI did not vary. There were no significant differences in adjusted 3-year rates of mortality (hazard ratio 0.73, 95% confidence interval 0.30 to 1.79) or composite major adverse clinical events (death, myocardial infarction, target vessel revascularization, or stroke; hazard ratio 0.71, 95% confidence interval 0.44 to 1.15) in patients with versus without postprocedural sustained VT/VF. In conclusion, sustained VT/VF after PPCI in the HORIZONS-AMI trial was not significantly associated with 3-year mortality or major adverse clinical events. Further studies are required to address the prognostic significance of VT/VF in patients with STEMI undergoing PPCI.
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0ISSN: 0002-9149
1EISSN: 1879-1913
2DOI: 10.1016/j.amjcard.2011.10.043
3PMID: 22196782
4CODEN: AJCDAG
languageeng
publisherNew York, NY: Elsevier Inc
subjectAbnormalities ; Abridged Index Medicus ; ACE inhibitors ; Adrenergic beta blockers ; Aged ; Angioplasty, Balloon, Coronary - adverse effects ; Angiotensin ; Biological and medical sciences ; Cardiac arrhythmia ; Cardiac dysrhythmias ; Cardiac patients ; Cardiology. Vascular system ; Cardiovascular ; Clinical trials ; Diabetes ; Diseases of the cardiovascular system ; Electrocardiography ; Enzyme inhibitors ; Enzymes ; Female ; Follow-Up Studies ; Heart ; Heart attacks ; Humans ; Hypertension ; Incidence ; Male ; Medical sciences ; Middle Aged ; Mortality ; Muscle contraction ; Myocardial Infarction - physiopathology ; Myocardial Infarction - therapy ; Prognosis ; Prospective Studies ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Risk Factors ; Tachycardia ; Tachycardia, Ventricular - epidemiology ; Tachycardia, Ventricular - etiology ; Tachycardia, Ventricular - physiopathology ; Time Factors ; Transluminal angioplasty ; United States - epidemiology ; Ventricular Fibrillation - epidemiology ; Ventricular Fibrillation - etiology ; Ventricular Fibrillation - physiopathology ; Ventricular tachycardia
ispartofThe American journal of cardiology, 2012, Vol.109 (6), p.805-812
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1Yu, Jennifer, MBBS
2Piccini, Jonathan P., MD
3Tcheng, James E., MD
4Farkouh, Michael E., MD
5Reiffel, James, MD
6Fahy, Martin, MSc
7Mehran, Roxana, MD
8Stone, Gregg W., MD
title
0Prognostic Significance of Postprocedural Sustained Ventricular Tachycardia or Fibrillation in Patients Undergoing Primary Percutaneous Coronary Intervention (from the HORIZONS-AMI Trial)
1The American journal of cardiology
addtitleAm J Cardiol
descriptionThe prognostic significance of postprocedure sustained ventricular tachycardia or ventricular fibrillation (VT/VF) in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) has rarely been studied, although a previous study has suggested that its occurrence portends decreased survival. We examined outcomes from the prospective large-scale multicenter randomized HORIZONS-AMI trial to evaluate the incidence, clinical correlates, and outcomes of in-hospital sustained VT/VF after PPCI. Of 3,485 patients undergoing PPCI in whom VT/VF did not occur before or during the procedure, 181 patients (5.2%) developed VT/VF after PPCI. Most postprocedural VT/VF episodes (85%) occurred in the first 48 hours. Patients with postprocedural VT/VF were more likely men with Killip class >I on presentation but had a lower prevalence of hypertension and diabetes. Patients with postprocedural VT/VF were also less frequently taking β blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers at admission. Mean door-to-balloon time was shorter and Thrombolysis In Myocardial Infarction grade 0 flow before PPCI was more common in patients with VT/VF, although Thrombolysis In Myocardial Infarction grade 3 flow rates after PPCI did not vary. There were no significant differences in adjusted 3-year rates of mortality (hazard ratio 0.73, 95% confidence interval 0.30 to 1.79) or composite major adverse clinical events (death, myocardial infarction, target vessel revascularization, or stroke; hazard ratio 0.71, 95% confidence interval 0.44 to 1.15) in patients with versus without postprocedural sustained VT/VF. In conclusion, sustained VT/VF after PPCI in the HORIZONS-AMI trial was not significantly associated with 3-year mortality or major adverse clinical events. Further studies are required to address the prognostic significance of VT/VF in patients with STEMI undergoing PPCI.
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0Abnormalities
1Abridged Index Medicus
2ACE inhibitors
3Adrenergic beta blockers
4Aged
5Angioplasty, Balloon, Coronary - adverse effects
6Angiotensin
7Biological and medical sciences
8Cardiac arrhythmia
9Cardiac dysrhythmias
10Cardiac patients
11Cardiology. Vascular system
12Cardiovascular
13Clinical trials
14Diabetes
15Diseases of the cardiovascular system
16Electrocardiography
17Enzyme inhibitors
18Enzymes
19Female
20Follow-Up Studies
21Heart
22Heart attacks
23Humans
24Hypertension
25Incidence
26Male
27Medical sciences
28Middle Aged
29Mortality
30Muscle contraction
31Myocardial Infarction - physiopathology
32Myocardial Infarction - therapy
33Prognosis
34Prospective Studies
35Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
36Risk Factors
37Tachycardia
38Tachycardia, Ventricular - epidemiology
39Tachycardia, Ventricular - etiology
40Tachycardia, Ventricular - physiopathology
41Time Factors
42Transluminal angioplasty
43United States - epidemiology
44Ventricular Fibrillation - epidemiology
45Ventricular Fibrillation - etiology
46Ventricular Fibrillation - physiopathology
47Ventricular tachycardia
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titlePrognostic Significance of Postprocedural Sustained Ventricular Tachycardia or Fibrillation in Patients Undergoing Primary Percutaneous Coronary Intervention (from the HORIZONS-AMI Trial)
authorMehta, Rajendra H., MD, MS ; Yu, Jennifer, MBBS ; Piccini, Jonathan P., MD ; Tcheng, James E., MD ; Farkouh, Michael E., MD ; Reiffel, James, MD ; Fahy, Martin, MSc ; Mehran, Roxana, MD ; Stone, Gregg W., MD
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1Abridged Index Medicus
2ACE inhibitors
3Adrenergic beta blockers
4Aged
5Angioplasty, Balloon, Coronary - adverse effects
6Angiotensin
7Biological and medical sciences
8Cardiac arrhythmia
9Cardiac dysrhythmias
10Cardiac patients
11Cardiology. Vascular system
12Cardiovascular
13Clinical trials
14Diabetes
15Diseases of the cardiovascular system
16Electrocardiography
17Enzyme inhibitors
18Enzymes
19Female
20Follow-Up Studies
21Heart
22Heart attacks
23Humans
24Hypertension
25Incidence
26Male
27Medical sciences
28Middle Aged
29Mortality
30Muscle contraction
31Myocardial Infarction - physiopathology
32Myocardial Infarction - therapy
33Prognosis
34Prospective Studies
35Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
36Risk Factors
37Tachycardia
38Tachycardia, Ventricular - epidemiology
39Tachycardia, Ventricular - etiology
40Tachycardia, Ventricular - physiopathology
41Time Factors
42Transluminal angioplasty
43United States - epidemiology
44Ventricular Fibrillation - epidemiology
45Ventricular Fibrillation - etiology
46Ventricular Fibrillation - physiopathology
47Ventricular tachycardia
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6Fahy, Martin, MSc
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atitlePrognostic Significance of Postprocedural Sustained Ventricular Tachycardia or Fibrillation in Patients Undergoing Primary Percutaneous Coronary Intervention (from the HORIZONS-AMI Trial)
jtitleThe American journal of cardiology
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abstractThe prognostic significance of postprocedure sustained ventricular tachycardia or ventricular fibrillation (VT/VF) in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) has rarely been studied, although a previous study has suggested that its occurrence portends decreased survival. We examined outcomes from the prospective large-scale multicenter randomized HORIZONS-AMI trial to evaluate the incidence, clinical correlates, and outcomes of in-hospital sustained VT/VF after PPCI. Of 3,485 patients undergoing PPCI in whom VT/VF did not occur before or during the procedure, 181 patients (5.2%) developed VT/VF after PPCI. Most postprocedural VT/VF episodes (85%) occurred in the first 48 hours. Patients with postprocedural VT/VF were more likely men with Killip class >I on presentation but had a lower prevalence of hypertension and diabetes. Patients with postprocedural VT/VF were also less frequently taking β blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers at admission. Mean door-to-balloon time was shorter and Thrombolysis In Myocardial Infarction grade 0 flow before PPCI was more common in patients with VT/VF, although Thrombolysis In Myocardial Infarction grade 3 flow rates after PPCI did not vary. There were no significant differences in adjusted 3-year rates of mortality (hazard ratio 0.73, 95% confidence interval 0.30 to 1.79) or composite major adverse clinical events (death, myocardial infarction, target vessel revascularization, or stroke; hazard ratio 0.71, 95% confidence interval 0.44 to 1.15) in patients with versus without postprocedural sustained VT/VF. In conclusion, sustained VT/VF after PPCI in the HORIZONS-AMI trial was not significantly associated with 3-year mortality or major adverse clinical events. Further studies are required to address the prognostic significance of VT/VF in patients with STEMI undergoing PPCI.
copNew York, NY
pubElsevier Inc
pmid22196782
doi10.1016/j.amjcard.2011.10.043