Document Detail


Ventricular arrhythmias after acute myocardial infarction: a 20-year community study.
MedLine Citation:
PMID:  16569539     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although myocardial infarction (MI) severity is declining, the occurrence of ventricular arrhythmia (VA) after MI and its effect on outcome is unknown. This study was undertaken to examine the frequency and timing of VA and the effect of VA on mortality after MI. METHODS: Myocardial infarctions recorded between 1979 and 1998 were validated. Baseline characteristics, occurrence of VA, and survival were determined. Ventricular arrhythmias were categorized as primary ventricular fibrillation (VF), nonprimary VF, and ventricular tachycardia (VT). Logistic regression was used to analyze associations between VA and baseline characteristics. Temporal trends were assessed with the Mantel-Haenszel chi2. Survival was analyzed with the Kaplan-Meier method. Proportional hazards regression was used to examine the association between death and occurrence of VA. RESULTS: Among 2317 persons with incident MI, 7.5% experienced VA (3.6% nonprimary VF, 2.1% primary VF, 1.8% VT). Ventricular arrhythmia-associated factors were younger age, female sex, higher Killip class, ST elevation, and atrial fibrillation. Ventricular arrhythmias were associated with increased risk of death at 30 days. CONCLUSION: Ventricular arrhythmias after MI are relatively common, particularly among persons with more severe MI and no prior history of coronary disease. Over time, the incidence of VF declined, whereas VT did not change. Ventricular arrhythmia after MI was associated with a 6-fold increase in morality. Thus, identification of high-risk MI survivors and prevention of VA could markedly improve outcomes. Further studies are needed to determine the cause of the shift in distribution of VA subtype.
Authors:
Danielle M Henkel; Brandi J Witt; Bernard J Gersh; Steven J Jacobsen; Susan A Weston; Ryan A Meverden; Véronique L Roger
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  151     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-03-29     Completed Date:  2006-04-21     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  806-12     Citation Subset:  AIM; IM    
Affiliation:
Mayo Clinic College of Medicine, Rochester, MN, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Female
Humans
Logistic Models
Male
Middle Aged
Myocardial Infarction / complications*,  mortality
Risk Factors
Survival Analysis
Tachycardia, Ventricular / etiology*
Ventricular Fibrillation / epidemiology
Grant Support
ID/Acronym/Agency:
AR30582/AR/NIAMS NIH HHS; HL59205/HL/NHLBI NIH HHS

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