Document Detail


Prognosis after cardiac arrest due to ventricular tachycardia or ventricular fibrillation associated with acute myocardial infarction (the MILIS Study). Multicenter Investigation of the Limitation of Infarct Size.
MedLine Citation:
PMID:  3661389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Previous studies have reached conflicting conclusions about whether cardiac arrest due to ventricular tachycardia (VT) or ventricular fibrillation (VF) in acute myocardial infarction (AMI) is of long-term prognostic significance. The mortality rate in 849 patients with confirmed AMI was analyzed. The mortality rate during the initial hospitalization was higher for patients in whom VT/VF occurred (27% vs 7%, p less than 0.001). The in-hospital mortality rate for patients with primary VT/VF, that is, VT/VF occurring in the absence of hypotension or heart failure, was similar to that of patients who did not have VT/VF (8% vs 7%, difference not significant), whereas the rate for patients with secondary VT/VF was significantly greater than that for patients with no VT/VF (51% vs 7%, p less than 0.001). The timing of occurrence of VT/VF also influenced mortality: Patients in whom VT/VF occurred more than 72 hours after admission had a higher in-hospital mortality rate than did patients in whom it occurred within 72 hours (57% vs 20%, p less than 0.05). All cases of primary VT/VF occurred within the first 72 hours of admission. The long-term mortality rate for hospital survivors was not significantly different for patients who had had VT/VF during acute infarction compared with those who had not (19% vs 21%) (mean follow-up 32 months). Thus, cardiac arrest due to ventricular tachyarrhythmia was associated with a higher in-hospital mortality rate but was not a prognostic factor among hospital survivors. Patients resuscitated from primary VT/VF, which characteristically occurs early after AMI, do not have an adverse prognosis.
Authors:
G H Tofler; P H Stone; J E Muller; J D Rutherford; S N Willich; N F Gustafson; W K Poole; B E Sobel; J T Willerson; T Robertson
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  60     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1987 Oct 
Date Detail:
Created Date:  1987-11-13     Completed Date:  1987-11-13     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  755-61     Citation Subset:  AIM; IM    
Affiliation:
Harvard Medical School, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115.
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Heart Arrest / etiology*,  mortality
Heart Function Tests
Heart Ventricles
Humans
Male
Middle Aged
Myocardial Infarction / complications*,  mortality
Probability
Prognosis
Tachycardia / complications*,  mortality
Time Factors
Ventricular Fibrillation / complications*,  mortality
Grant Support
ID/Acronym/Agency:
N01-HV-7-2940/HV/NHLBI NIH HHS; N01-HV-7-2941/HV/NHLBI NIH HHS; N01-HV-7-2942/HV/NHLBI NIH HHS

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


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