The Relationship Between Primary Ventricular Arrhythmias and In-hospital Mortality and Resuscitated Cardiopulmonary Arrest in Patients with Acute ST Segment Elevation Myocardial Infarction

Abstract

Aim: Arrhythmic complications in patients with acute coronary syndromes during hospitalization are not uncommon in cardiology practice. In our retrospective study, we investigated the effect of primary ventricular arrhythmias occurring within the first 48 hours from the time of hospitalization on cardiovascular mortality and resuscitated cardiopulmonary arrest in patients with ST-segment elevation myocardial infarction. Introduction: Although the rate of myocardial infarction has decreased over the years, it is responsible for hundreds of thousands of deaths worldwide. Arrhythmic complications take an essential place for morbidity and mortality in the course of myocardial infarction. Ventricular arrhythmias play a pivotal role in terms of mortality in acute terms of myocardial infarction. Material and Method: In our single center and retrospective study, 18-year-old and older patients who presented to Sağlik Bilimleri University Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital emergency department with ischemic symptoms and were admitted to hospital with the diagnose of ST-segment elevation myocardial infarction were enrolled. The primary endpoint was in-hospital mortality and resuscitated cardiopulmonary arrest. Results: 1,137 patients were included in the study. Primary VT/VF which occurred within the first 48 hours from the time of hospitalization was observed in 8.2% of patients (n: 93). Previous MI history (3.47 OR, 95% CI 1.41–8.55 p=0.0068, LASSO: 0.388), KILLIP class at the time of admission (1.52 OR, 95% CI 0.94–2.45 p=0.0813, LASSO: 0.627), Primary VT/VF (4.02 OR, 95% CI 1.44–11.21 p=0.0077, LASSO: 0.440), left ventricle ejection fraction calculated by transthoracic echocardiography (0.88 OR, 95% CI 0.78–0.99 p=0.0444, LASSO: -0.032) and serum CRP level (1.81 OR, 95% CI 0.22–14.53 p=0.57, LASSO: 0.036) were independent predictors of MACE including in-hospital mortality and resuscitated cardiopulmonary arrest. Conclusion: Primary VT and VF are independent predictors of inhospital mortality and resuscitated cardiopulmonary arrest events in patients with ST-segment elevation acute MI.

Keywords

• myocardial infarction
• STEMI
• ventricular arrhythmias
• in-hospital mortality

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