Prognostic Impact of Acute Myocardial Infarction in Patients Presenting With Ventricular Tachyarrhythmias and Aborted Cardiac Arrest

Behnes, Michael; Mashayekhi, Kambis; Weiß, Christel; Nienaber, Christoph; Lang, Siegfried; Reiser, Linda; Bollow, Armin; Taton, Gabriel; Reichelt, Thomas; Ellguth, Dominik; Engelke, Niko; Schupp, Tobias; Ansari, Uzair; El‐Battrawy, Ibrahim; Rusnak, Jonas; Akin, Muharrem; Borggrefe, Martin; Akın, İbrahim

doi:10.1161/jaha.118.010004

Cited by 28 publications

(30 citation statements)

References 30 publications

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“…However, a prior study that was limited to patients with a pre-OHCA diagnosis of ischaemic heart disease reported higher odds for survival to discharge in these patients. 2 Also, other investigators reported that OHCA patients without AMI who survived to hospital admission had higher mortality rates than OHCA patients with AMI, 22 which may be related to postcardiac arrest shock. 23 Nevertheless, another study that was limited to patients with ischaemic heart disease and congenital heart disease reported a lower survival chance to hospital discharge in these patients.…”

Section: Discussionmentioning

confidence: 99%

Higher chances of survival to hospital admission after out-of-hospital cardiac arrest in patients with previously diagnosed heart disease

et al. 2021

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AimThis study aimed to determine whether patients suffering from out-of-hospital cardiac arrest (OHCA) with a pre-OHCA diagnosis of heart disease have higher survival chances than patients without such a diagnosis and to explore possible underlying mechanisms.MethodsA retrospective cohort study in 3760 OHCA patients from the Netherlands (2010–2016) was performed. Information from emergency medical services, treating hospitals, general practitioner, resuscitation ECGs and civil registry was used to assess medical histories and the presence of pre-OHCA diagnosis of heart disease. We used multivariable regression analysis to calculate associations with survival to hospital admission or discharge, immediate causes of OHCA (acute myocardial infarction (AMI) vs non-AMI) and initial recorded rhythm.ResultsOverall, 48.1% of OHCA patients had pre-OHCA heart disease. These patients had higher odds to survive to hospital admission than patients without pre-OHCA heart disease (OR 1.25 (95%CI 1.05 to 1.47)), despite being older and more often having cardiovascular risk factors and some non-cardiac comorbidities. These patients also had higher odds of shockable initial rhythm (SIR) (OR 1.60 (1. 36 to 1.89)) and a lower odds of AMI as immediate cause of OHCA (OR 0.33 (0.25 to 0.42)). Their chances of survival to hospital discharge were not significantly larger (OR 1.16 (0.95 to 1.42)).ConclusionHaving pre-OHCA diagnosed heart disease is associated with better odds to survive to hospital admission, but not to hospital discharge. This is associated with higher odds of a SIR and in a subgroup with available diagnosis a lower proportion of AMI as immediate cause of OHCA.

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Section: Discussionmentioning

confidence: 99%

Higher chances of survival to hospital admission after out-of-hospital cardiac arrest in patients with previously diagnosed heart disease

et al. 2021

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“…These findings suggest that ES patients, even when compared to a highest-risk cohort of patients with AMI-VTA represent a population of utmost risk for cardiovascular death. Even after exclusion of patients suffering from VTA within 48 h after AMI ES patients remained at highest for subsequent mortality [3]. Accordingly, this impaired prognosis could be also confirmed in multivariable regression models.…”

Section: Discussionmentioning

confidence: 69%

“…Both, electrical storm (ES) and acute myocardial infarction complicated by ventricular tachyarrhythmias (AMI-VTA) represent life-threatening clinical conditions. Up to 6% of acute coronary syndrome (ACS) cases are complicated by ventricular tachyarrhythmias and associated with an unfavorable clinical outcome [1][2][3]. Irreversible myocardial ischemia alleviates the development of focal and non-focal arrhythmogenic sources degenerating into ventricular tachycardia (VT) or fibrillation (VF) [4,5].…”

Section: Introductionmentioning

confidence: 99%

Electrical storm reveals worse prognosis compared to myocardial infarction complicated by ventricular tachyarrhythmias in ICD recipients

et al. 2021

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Both acute myocardial infarction complicated by ventricular tachyarrhythmias (AMI–VTA) and electrical storm (ES) represent life-threatening clinical conditions. However, a direct comparison of both sub-groups regarding prognostic endpoints has never been investigated. All consecutive implantable cardioverter-defibrillator (ICD) recipients were included retrospectively from 2002 to 2016. Patients with ES apart from AMI (ES) were compared to patients with AMI accompanied by ventricular tachyarrhythmias (AMI–VTA). The primary endpoint was all-cause mortality at 3 years, secondary endpoints were in-hospital mortality, rehospitalization rates and major adverse cardiac event (MACE) at 3 years. A total of 198 consecutive ICD recipients were included (AMI–VTA: 56%; ST-segment elevation myocardial infarction (STEMI): 22%; non-ST-segment myocardial infarction (NSTEMI) 78%; ES: 44%). ES patients were older and had higher rates of severely reduced left ventricular ejection fraction (LVEF) < 35%. ES was associated with increased all-cause mortality at 3 years (37% vs. 19%; p = 0.001; hazard ratio [HR] = 2.242; 95% CI 2.291–3.894; p = 0.004) and with increased risk of first cardiac rehospitalization (44% vs. 12%; p = 0.001; HR = 4.694; 95% CI 2.498–8.823; p = 0.001). This worse prognosis of ES compared to AMI–VTA was still evident after multivariable adjustment (long-term all-cause mortality: HR = 2.504; 95% CI 1.093–5.739; p = 0.030; first cardiac rehospitalization: HR = 2.887; 95% CI 1.240–6.720; p = 0.014). In contrast, the rates of MACE (40% vs. 32%; p = 0.326) were comparable in both groups. At long-term follow-up of 3 years, ES was associated with higher rates of all-cause mortality and rehospitalization compared to patients with AMI–VTA.

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“…In the acute phase, the clinical presentation, electrocardiographic findings and biomarker profiles are often similar to those of an ACS (Templin et al, 2015). There are different complications which have been reported in connection to TTS, such as cardiogenic shock, sudden cardiac arrest, thromboembolic events, mitral valve regurgitation, and atrial fibrillation (Stiermaier et al, 2015;El-Battrawy et al, 2016;El-Battrawy et al, 2017a;El-Battrawy et al, 2017b;El-Battrawy et al, 2018a), and also have been reported in connection to ACS (Lavie and Gersh, 1990;Baja et al, 2015;Behnes et al, 2018).…”

Section: Introductionmentioning

confidence: 92%

The Use of Beta Blockers in Takotsubo Syndrome as Compared to Acute Coronary Syndrome

et al. 2020

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Background: Takotsubo syndrome (TTS) and acute coronary syndrome (ACS) patients have a similar mortality rate. In this study, we sought to determine the short-and long-term outcome of TTS patients as compared to ACS patients both treated with beta-blockers. Objectives: In the present study we described the data of 5 years of follow up of 103 TTS and 422 ACS patients both treated with beta-blockers. Methods: Data from TTS patients were included retrospectively and prospectively, ACS patients were included retrospectively. All retrospectively included patients have been followed up for 5 years. The end point in this study was the occurrence of death. Results: TTS affected significantly more women (87.4%) than ACS (34.6%) (p < 0.01). TTS patients suffered significantly more often from thromboembolic events (14.6% versus 2.1%; p < 0.01) and cardiogenic shock (11.9% versus 3.6%; p < 0.01) than the ACS group. TTS patients had a significantly higher long-term mortality (within 5 years) as compared to ACS patients (17.5% versus 3.6%) (p < 0.01). Patients of the TTS group compared to the ACS group did not benefit from combination of beta-blockers and ACEinhibitors in terms of long-term mortality (p < 0.01). As we compare TTS patients who were treated with beta-blockers and ACE-inhibitors versus single use of beta-blockers there was no difference in long-term mortality (p = 0.918). Conclusion: TTS patients had a significantly higher long-term mortality (within 5 years) than patients with an ACS.

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Prognostic Impact of Acute Myocardial Infarction in Patients Presenting With Ventricular Tachyarrhythmias and Aborted Cardiac Arrest

Cited by 28 publications

References 30 publications

Higher chances of survival to hospital admission after out-of-hospital cardiac arrest in patients with previously diagnosed heart disease

Higher chances of survival to hospital admission after out-of-hospital cardiac arrest in patients with previously diagnosed heart disease

Electrical storm reveals worse prognosis compared to myocardial infarction complicated by ventricular tachyarrhythmias in ICD recipients

The Use of Beta Blockers in Takotsubo Syndrome as Compared to Acute Coronary Syndrome

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