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Incidence of ventricular arrhythmia and associated patient outcomes in hospitalized acute coronary syndrome patients in Saudi Arabia: findings from the registry of the Saudi Project for Assessment of Acute Coronary Syndrome (SPACE).
MedLine Citation:
PMID:  22705607     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Mortality in acute coronary syndrome (ACS) patients with ventricular arrhythmia (VA) has been shown to be higher than those without VA. However, there is a paucity of data on VA among ACS patients in the Middle Eastern countries.
DESIGN AND SETTING: Prospective study of patients admitted in 17 government hospitals with ACS between December 2005 and December 2007.
PATIENTS AND METHODS: Patients were categorized as having VA if they experienced either ventricular fibrillation (VF) or sustained ventricular tachycardia (VT) or both.
RESULTS: Of 5055 patients with ACS enrolled in the SPACE registry, 168 (3.3%) were diagnosed with VA and 151 (98.8%) occurred in-hospital. The vast majority (74.4%) occurred in patients with ST-segment elevation myocardial infarction. In addition, males were twice as likely to develop VA than females (OR 1.7; 95% CI 1.13). Killip class >I (OR 2.0; 95% CI 1.3-3.1); and systolic blood pressure <90 mm Hg (OR 6.4; 95% CI 3.5-11.8) were positively associated with VA. Those admitted with hyperlipidemia (OR 0.49; 95% CI 0.3-0.7) had a lower risk of developing VA. Adverse in-hospital outcomes including re-myocardial infarction, cardiogenic shock, congestive heart failure, major bleeding, and stroke were higher for patients with VA (P≤.01 for all variables) and signified a poor prognosis. The in-hospital mortality rate was significantly higher in VA patients compared with non-VA patients (27% vs 2.2%; P=.001).
CONCLUSIONS: In-hospital VA in Saudi patients with ACS was associated with remarkably high rates of adverse events and increased in-hospital mortality. Using a well-developed registry data with a large number of patients, our study documented for the first time the prevalence and risk factors of VA in unselected population of ACS.
Authors:
Ahmad S Hersi; Khalid F Alhabib; Hussam F Alfaleh; Khalid Alnemer; Shukri Alsaif; Amir Taraben; Tarek Kashour; Ahmed M Abuosa; Mushabab A Al-Murayeh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of Saudi medicine     Volume:  32     ISSN:  0975-4466     ISO Abbreviation:  Ann Saudi Med     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507355     Medline TA:  Ann Saudi Med     Country:  India    
Other Details:
Languages:  eng     Pagination:  372-7     Citation Subset:  IM    
Affiliation:
Ahmad S. Hersi, MD, Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia T: +9661 4671161 ahersi@ksu.edu.sa.
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