Background The study sought to assess the prognostic impact of acute myocardial infarction ( AMI ) with and without ST ‐segment–elevation myocardial infarction ( STEMI and NSTEMI ) in patients with ventricular tachyarrhythmias and sudden cardiac arrest ( SCA ) on admission. Methods and Results A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia ( VT ), fibrillation ( VF ), and sudden cardiac arrest ( SCA ) on admission from 2002 to 2016. AMI versus non‐ AMI and STEMI versus NSTEMI were compared applying multivariable Cox regression models and propensity‐score matching for evaluation of the primary prognostic end point defined as long‐term all‐cause mortality at 2.5 years. Secondary end points were 30 days all‐cause mortality, cardiac death at 24 hours, in hospital death, and recurrent percutaneous coronary intervention (re‐ PCI ) at 2.5 years. In 2813 unmatched high‐risk patients with ventricular tachyarrhythmias and SCA , AMI was present in 29% (10% STEMI , 19% NSTEMI ) with higher rates of VF (54% versus 31%) and SCA (35% versus 26%), whereas VT rates were higher in non‐ AMI (56% versus 30%) ( P < 0.05). AMI ‐related VT ≥48 hours was associated with higher mortality (log rank P = 0.001). Multivariable Cox regression models revealed non‐ AMI (hazard ratio = 1.458; P = 0.001) and NSTEMI (hazard ratio = 1.460; P = 0.036) associated with increasing long‐term all‐cause mortality at 2.5 years, which was also proven after propensity‐score matching (non‐ AMI versus AMI : 55% versus 43%, log rank P = 0.001, hazard ratio = 1.349; NSTEMI versus STEMI : 45% versus 34%, log rank P = 0.047, hazard ratio = 1.372). Secondary end points including 30 days and in‐hospital mortality, as well as re‐ PCI were higher in non‐ AMI patients. Conclusions In high‐risk patients presenting with ventricular tachyarrhythmias and SCA , non‐ AMI revealed higher mortality tha...

ClinicalTrials.gov identifier: NCT02982473.

ObjectivesThe study sought to assess the prognostic impact of type 2 diabetes in patients presenting with ventricular tachyarrhythmias on admission.BackgroundData regarding the prognostic outcome of diabetics presenting with ventricular tachyarrhythmias is limited.MethodsA large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT) and fibrillation (VF) on admission from 2002 to 2016. Patients with type 2 diabetes (diabetics) were compared to non-diabetics applying multivariable Cox regression models and propensity-score matching for evaluation of the primary prognostic endpoint of long-term all-cause mortality at 2 years. Secondary prognostic endpoints were cardiac death at 24 h, in-hospital death at index, all-cause mortality at 30 days, all-cause mortality in patients surviving index hospitalization at 2 years (i.e. “after discharge”) and rehospitalization due to recurrent ventricular tachyarrhythmias at 2 years.ResultsIn 2411 unmatched high-risk patients with ventricular tachyarrhythmias, diabetes was present in 25% compared to non-diabetics (75%). Rates of VT (57% vs. 56%) and VF (43% vs. 44%) were comparable in both groups. Multivariable Cox regression models revealed diabetics associated with the primary endpoint of long-term all-cause mortality at 2 years (HR = 1.513; p = 0.001), which was still proven after propensity score matching (46% vs. 33%, log rank p = 0.001; HR = 1.525; p = 0.001). The rates of secondary endpoints were higher for in-hospital death at index, all-cause mortality at 30 days, as well as after discharge, but not for cardiac death at 24 h or rehospitalization due to recurrent ventricular tachyarrhythmias.ConclusionPresence of type 2 diabetes is independently associated with an increase of all-cause mortality in patients presenting with ventricular tachyarrhythmias on admission.