Skip to main content

Sustained ventricular arrhythmias among patients with acute coronary syndromes with no ST-segment elevation: incidence, predictors, and outcomes.

Publication ,  Journal Article
Al-Khatib, SM; Granger, CB; Huang, Y; Lee, KL; Califf, RM; Simoons, ML; Armstrong, PW; Van de Werf, F; White, HD; Simes, RJ; Moliterno, DJ ...
Published in: Circulation
July 16, 2002

BACKGROUND: The prognosis of ventricular arrhythmias among patients with non-ST-elevation acute coronary syndromes is unknown. We studied the incidence, predictors, and outcomes of sustained ventricular arrhythmias in 4 large randomized trials of such patients. METHODS AND RESULTS: We pooled the datasets of the Global Use of Streptokinase and tPA for Occluded Arteries (GUSTO)-IIb, Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT), Platelet IIb/IIIa Antagonism for the Reduction of Acute Coronary Syndrome Events in a Global Organization Network (PARAGON)-A, and PARAGON-B trials (n=26 416). We identified independent predictors of ventricular fibrillation (VF) and ventricular tachycardia (VT) and compared the 30-day and 6-month mortality rates of patients who did (n=552) and did not (n=25 864) develop these arrhythmias during the index hospitalization. Independent predictors of in-hospital VF included prior hypertension, chronic obstructive pulmonary disease, prior myocardial infarction, and ST-segment changes at presentation. Except for hypertension, these variables also independently predicted in-hospital VT. In Cox proportional-hazards modeling, in-hospital VF and VT were independently associated with 30-day mortality (hazard ratio [HR], 23.2 [95% CI, 18.1 to 29.8] for VF and HR, 7.6 [95% CI, 5.5 to 10.4] for VT) and 6-month mortality (HR, 14.8 [95% CI, 12.1 to 18.3] for VF and HR, 5.0 [95% CI, 3.8 to 6.5] for VT). These differences remained significant after excluding patients with heart failure or cardiogenic shock and those who died <24 hours after enrollment. CONCLUSIONS: Despite the use of effective therapies for non-ST-elevation acute coronary syndromes, ventricular arrhythmias in this setting are associated with increased 30-day and 6-month mortality. More effective therapies are needed to improve the survival of patients with these arrhythmias.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

July 16, 2002

Volume

106

Issue

3

Start / End Page

309 / 312

Location

United States

Related Subject Headings

  • Ventricular Fibrillation
  • Treatment Outcome
  • Tachycardia, Ventricular
  • Syndrome
  • Risk Factors
  • Randomized Controlled Trials as Topic
  • Prognosis
  • Male
  • Incidence
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Al-Khatib, S. M., Granger, C. B., Huang, Y., Lee, K. L., Califf, R. M., Simoons, M. L., … Harrington, R. A. (2002). Sustained ventricular arrhythmias among patients with acute coronary syndromes with no ST-segment elevation: incidence, predictors, and outcomes. Circulation, 106(3), 309–312. https://doi.org/10.1161/01.cir.0000022692.49934.e3
Al-Khatib, Sana M., Christopher B. Granger, Yao Huang, Kerry L. Lee, Robert M. Califf, Maarten L. Simoons, Paul W. Armstrong, et al. “Sustained ventricular arrhythmias among patients with acute coronary syndromes with no ST-segment elevation: incidence, predictors, and outcomes.Circulation 106, no. 3 (July 16, 2002): 309–12. https://doi.org/10.1161/01.cir.0000022692.49934.e3.
Al-Khatib SM, Granger CB, Huang Y, Lee KL, Califf RM, Simoons ML, et al. Sustained ventricular arrhythmias among patients with acute coronary syndromes with no ST-segment elevation: incidence, predictors, and outcomes. Circulation. 2002 Jul 16;106(3):309–12.
Al-Khatib, Sana M., et al. “Sustained ventricular arrhythmias among patients with acute coronary syndromes with no ST-segment elevation: incidence, predictors, and outcomes.Circulation, vol. 106, no. 3, July 2002, pp. 309–12. Pubmed, doi:10.1161/01.cir.0000022692.49934.e3.
Al-Khatib SM, Granger CB, Huang Y, Lee KL, Califf RM, Simoons ML, Armstrong PW, Van de Werf F, White HD, Simes RJ, Moliterno DJ, Topol EJ, Harrington RA. Sustained ventricular arrhythmias among patients with acute coronary syndromes with no ST-segment elevation: incidence, predictors, and outcomes. Circulation. 2002 Jul 16;106(3):309–312.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

July 16, 2002

Volume

106

Issue

3

Start / End Page

309 / 312

Location

United States

Related Subject Headings

  • Ventricular Fibrillation
  • Treatment Outcome
  • Tachycardia, Ventricular
  • Syndrome
  • Risk Factors
  • Randomized Controlled Trials as Topic
  • Prognosis
  • Male
  • Incidence
  • Humans