Document Detail

Prevalence and prognostic implications of non-sustained ventricular tachycardia in ST-segment elevation myocardial infarction after revascularization with either fibrinolysis or primary angioplasty.
MedLine Citation:
PMID:  17227787     Owner:  NLM     Status:  MEDLINE    
AIMS: We compared the prevalence and prognostic implications of non-sustained ventricular tachycardia (nsVT) detected early after ST-segment elevation myocardial infarction (STEMI) in patients randomized to either fibrinolysis or primary angioplasty in the DANAMI-2 trial. METHODS AND RESULTS: Holter recordings were available in 1017 patients (fibrinolysis: n=501; primary angioplasty: n=516). Primary endpoint was all-cause mortality. The prevalence of nsVT was 8.8% in fibrinolysis-treated, and 8.1% in primary angioplasty-treated patients (P=0.71). During 4519 patient-years of follow-up (median 4.3 years), 116 patients died [fibrinolysis vs. angioplasty: HR=1.1 (95% CI, 0.8-1.6), P=0.47]. In univariate analysis, nsVT patients treated with fibrinolysis, had significantly higher mortality when compared with those without nsVT (P<0.001). However, after adjustment for other relevant prespecified risk factors, the association between nsVT and mortality did not remain statistically significant. In patients treated with primary angioplasty, nsVT was not associated with mortality in either univariate or multivariate analyses. CONCLUSION: Immediate revascularization with primary angioplasty for STEMI does not affect the subsequent prevalence of nsVT when compared with fibrinolysis. After adjustment for other relevant risk factors, the prognostic value of nsVT detected early after STEMI is limited, regardless of the chosen reperfusion strategy.
Dan Eik Høfsten; Kristian Wachtell; Birgit Lund; Henning Mølgaard; Kenneth Egstrup
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-01-16
Journal Detail:
Title:  European heart journal     Volume:  28     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-16     Completed Date:  2007-11-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  407-14     Citation Subset:  IM    
Department of Medical Research, Svendborg Hospital, 5700 Svendborg, and Department of Cardiology, Skejby Sygehus, Arhus University Hospital, Denmark.
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MeSH Terms
Analysis of Variance
Angioplasty / mortality*
Electrocardiography, Ambulatory
Middle Aged
Myocardial Infarction / mortality,  physiopathology,  therapy*
Myocardial Revascularization / methods*,  mortality
Survival Analysis
Tachycardia, Ventricular / mortality,  physiopathology,  therapy*
Thrombolytic Therapy / mortality*
Ventricular Dysfunction, Left / etiology,  mortality,  physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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