Sudden cardiac arrest due to ventricular arrhythmia in patients with acute myocardial infarction
Abstract
Introduction: Sudden cardiac death has not decreased in the same way as mortality due to coronary heart disease, because of the high incidence of sudden cardiac arrest (SCA).
Objectives: To determine predictive factors of SCA due to ventricular arrhythmia in patients with acute myocardial infarction.
Method: An analytical study was carried out in the Cardiology Department of Las Tunas between 2011 and 2017. The population of study was 917 patients admitted with acute myocardial infarction. All 90 patients with SCA in ventricular arrhythmia represented the “case group”; the rest were the “control group”. Descriptive statistics were used, as well as a multiple logistic regression model; the odds ratios (OR) was calculated, with 95% reliability to determine the predictive factors.
Results: In the patients of the case group predominated: male sex (73%), biventricular infarction (24.7%), left ventricular ejection fraction (LVEF) <35% (18.9%) and deceased (41.1%); all these results compared to the control group. A 10.0% was given beta-blockers on their first medical assistance. Cardiogenic shock (OR 15.3), LVEF <35% (OR 8.51), creatine kinase >1200 IU (OR 2.77), obesity (OR 3.16), smoking (OR 2.28), ST-segment elevation/depression on the electrocardiogram >15 mm (OR 2.23) and anterior wall infarction (OR 2.39) were associated with SCA due to ventricular arrhythmia.
Conclusions: Cardiogenic shock, LVEF <35%, creatine kinase > 1200 IU, obesity, smoking, ST-segment elevation/depression on the electrocardiogram >15 mm and anterior wall infarction were predictive factors of SCA due to ventricular arrhythmia.
Downloads
References
1. Myerburg RJ, Castellanos A. Parada cardiaca y muerte súbita cardiaca. En: Mann DL, Zipes DP, Libby P, Bonow RO, eds. Braunwald. Tratado de Cardiología. Texto de Medicina Cardiovascular. 10ma Ed. Barcelona: Elsevier; 2016. P. 821-58.
2. Josephson ME. Sudden cardiac arrest. Indian Heart J. 2014;66(Supl 1):S2-3.
3. Koene RJ, Adkisson WO, Benditt DG. Syncope and the risk of sudden cardiac death: Evaluation, management, and prevention. J Arrhythm. 2017;33(6):533-44.
4. Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, et al. Guía ESC 2015 sobre el tratamiento de pacientes con arritmias ventriculares y prevención de la muerte súbita cardiaca. Rev Esp Cardiol [Internet]. 2016 [citado 12 Feb 2019];69(2):176.e1-e77. Disponible en: https://www.revespcardiol.org/es-pdf-S030089321600004X
5. Vedanthan R, Fuster V, Fischer A. Sudden cardiac death in low- and middle-income countries. Glob Heart. 2012;7(4):353-60.
6. Israel CW. Mechanisms of sudden cardiac death. Indian Heart J. 2014;66(Supl 1):S10-7.
7. Buxton AE, Lee KL, Hafley GE, Pires LA, Fisher JD, Gold MR, et al. Limitations of ejection fraction for prediction of sudden death risk in patients with coronary artery disease: Lessons from the MUSTT study. J Am Coll Cardiol. 2007;50(12):1150-7.
8. Chitnis N, Vooturi S, Hygriv Rao B. Sudden cardiac death early after ST elevation myocardial infarction with and without severe left ventricular dysfunction. Indian Heart J. 2014;66(6):569-73.
9. Lauer MS. Risk stratification for sudden cardiac death: a puzzle beyond p values. J Am Coll Cardiol. 2010;56(18):1484-5.
10. Haugaa KH, Grenne BL, Eek CH, Ersbøll M, Valeur N, Svendsen JH, et al. Strain echocardiography improves risk prediction of ventricular arrhythmias after myocardial infarction. JACC Cardiovasc Imaging. 2013;6(8):841-50.
11. Ministerio de Salud Pública. Anuario Estadístico de Salud 2017. La Habana: Dirección Nacional de Registros Médicos y Estadísticas de Salud; 2018.
12. Kim MH, Hwang HJ, Shim J, Uhm JS, Joung B, Pak HN, et al. Coronary angiographic characteristics of provocation test in vasospastic angina presented with sudden cardiac death or syncope. J Am Coll Cardiol [Internet]. 2012 [citado 15 Feb 2019];59:13(Supl):E731 [Resumen]. Disponible en: https://doi.org/10.1016/S0735-1097(12)60732-3
13. Garberich R, Sharkey S, Johnson D, Johnson B, Traverse J, Poulose A, Lips D, et al. Clinical characteristics and outcomes of cardiac arrest patients in the setting of ST-elevation myocardial infarction. J Am Coll Cardiol [Internet]. 2012 [citado 15 Feb 2019];67:13(Supl):42 [Resumen]. Disponible en: https://doi.org/10.1016/S0735-1097(16)30043-2
14. Kim C, Fahrenbruch CE, Cobb LA, Eisenberg MS. Out-of-hospital cardiac arrest in men and women. Circulation. 2001;104(22):2699-703.
15. Al-Khatib SM, Yancy CW, Solis P, Becker L, Benjamin EJ, Carrillo RG, et al. 2016 AHA/ACC Clinical Performance and Quality Measures for Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. J Am Coll Cardiol. 2017;69(6):712-44.
16. Ragupathi L, Pavri BB. Tools for risk stratification of sudden cardiac death: a review of the literature in different patient populations. Indian Heart J. 2014;66(Supl 1):S71-81.
17. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346(12):877-83.
18. Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G. A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. N Engl J Med. 1999;341(25):1882-90.
19. Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med. 2005;352(3):225-37.
20. Chew D, Huikuri H, Schmidt G, Kavanagh K, Dommasch M, Thomsen PE, et al. The degree of left ventricular ejection fraction change following myocardial infarction predicts risk of sudden cardiac arrest. J Am Coll Cardiol [Internet]. 2012 [citado 17 Feb 2019];65:10(Supl):A188 [Resumen]. Disponible en: https://doi.org/10.1016/S0735-1097(15)60188-7
21. Yodogawa K, Shimizu W. Noninvasive risk stratification of lethal ventricular arrhythmias and sudden cardiac death after myocardial infarction. J Arrhythm. 2014;30(4):230-4.
22. Reinier K, Narayanan K, Uy-Evanado A, Teodorescu C, Chugh H, Mack WJ, et al. Electrocardiographic markers and the left ventricular ejection fraction have cumulative effects on risk of sudden cardiac death. JACC Clin Electrophysiol. 2015;1(6):542-50.
23. Garg A. Primary prevention of sudden cardiac death - Challenge the guidelines. Indian Heart J. 2015;67(3):203-6.
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.