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Temporal Trends in Prognosis of Patients with Acute Coronary Syndrome Complicated by Ventricular Tachyarrhythmia
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  • Ella Yahud,
  • Avishag Laish Farkash,
  • Nir Shlomo,
  • Noam Fink,
  • Ilan Goldenberg,
  • Eli I. Lev,
  • Elad Asher
Ella Yahud
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Avishag Laish Farkash
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Nir Shlomo
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Ilan Goldenberg
University of Rochester
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Eli I. Lev
Assuta Ashdod Hospital
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Elad Asher
Shaare Zedek Medical Center
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Abstract

Objectives: To evaluate clinical characteristics and prognosis of patients presented with ventricular tachyarrhythmia (VTA) during the course of acute coronary syndrome (ACS) and to analyze it according to period of presentation. Background: VTA is an infrequent yet serious complication of ACS. There is limited data regarding the incidence and prognostic implications of VTA in the last decade as compared with the previous decade. Methods: We evaluated clinical characteristics, major adverse cardiovascular events, short and long- term mortality of patients hospitalized with ACS who were enrolled in the Acute Coronary Syndrome Israeli Survey (ACSIS) during the years 2000-2016. Patients were classified into three groups: no VTA, early VTA (≤48h of onset) and late VTA (>48h of onset). Data were analyzed according to decades of presentation (current decade vs. previous decade). Results: The study population comprised 15,200 patients. VTA occurred in 487 (3.2%) of patients. Early VTA presented in 373/487 (77%) patients and late VTA in 114/487 (23%) patients. VTA’s, occurring in ACS patients were associated with increased risk of in-hospital, 30-days, 1-year and 5-year mortality rates during both early and late periods in compared with no VTA. Moreover, late VTA was associated with the highest mortality rate with up to 65% in 5-year follow up (p<0.001). Nevertheless, late VTA was associated with lower mortality rate in the current decade (2008-2016) compared with last decade (2000-2006). Conclusions: Any VTA following ACS was associated with high short and long-term mortality rate. However, over the past decade there has been a significant improvement in survival rates, especially in patients with late VTA. This may be attributed to early and invasive reperfusion therapy, implantable cardioverter defibrillator implantation and better medical treatment.

Peer review status:IN REVISION

15 Mar 2021Submitted to International Journal of Clinical Practice
13 Apr 2021Submission Checks Completed
13 Apr 2021Assigned to Editor
15 Apr 2021Reviewer(s) Assigned
28 May 2021Review(s) Completed, Editorial Evaluation Pending
28 May 2021Editorial Decision: Revise Minor
11 Jun 20211st Revision Received
14 Jun 2021Assigned to Editor
14 Jun 2021Review(s) Completed, Editorial Evaluation Pending
14 Jun 2021Submission Checks Completed