| 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. | |
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MedLine Citation:
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PMID: 3661389 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: The American journal of cardiology Volume: 60 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1987 Oct |
Date Detail:
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Created Date: 1987-11-13 Completed Date: 1987-11-13 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 755-61 Citation Subset: AIM; IM |
Affiliation:
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Harvard Medical School, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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N01-HV-7-2940/HV/NHLBI NIH HHS; N01-HV-7-2941/HV/NHLBI NIH HHS; N01-HV-7-2942/HV/NHLBI NIH HHS |
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