1. Factors Associated With and Outcomes After Ventricular Fibrillation Before and During Primary Angioplasty in Patients With ST-Segment Elevation Myocardial Infarction.
- Author
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Jabbari, Reza, Risgaard, Bjarke, Fosbøl, Emil L., Scheike, Thomas, Philbert, Berit T., Winkel, Bo G., Albert, Christine M., Glinge, Charlotte, Ahtarovski, Kiril A., Haunsø, Stig, Køber, Lars, Jørgensen, Erik, Pedersen, Frants, Tfelt-Hansen, Jacob, and Engstrøm, Thomas
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CONFIDENCE intervals , *ELECTROCARDIOGRAPHY , *FACTOR analysis , *CARDIAC patients , *LONGITUDINAL method , *MYOCARDIAL infarction , *MYOCARDIAL revascularization , *PROBABILITY theory , *THROMBOLYTIC therapy , *TRANSLUMINAL angioplasty , *VENTRICULAR fibrillation , *LOGISTIC regression analysis , *TREATMENT effectiveness , *HUMAN research subjects , *PATIENT selection , *DATA analysis software , *DESCRIPTIVE statistics , *HOSPITAL mortality , *ODDS ratio - Abstract
We aimed to assess the risk factors and outcome of ventricular fibrillation (VF) before and during primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction. From 1999 to 2012, we consecutively enrolled 5,373 patients with ST-segment elevation myocardial infarction. In total, 410 of the patients had VF before and 88 had VF during PPCI. During a mean follow-up of 4.2 years, 1,196 subjects died. A logistic regression model identified younger age, anterior infarct, Killip class >I at admission, and a preprocedural Thrombolysis In Myocardial Infarction flow grade of 0 to I to be significantly associated with VF before PPCI, whereas inferior infarct, a preprocedural Thrombolysis In Myocardial Infarction flow grade of 0 to I, and Killip class >I at admission were significantly associated with VF during PPCI. All-cause mortality was evaluated using the Cox regression model. Compared with the patients without VF, those with VF before or during PPCI had a significantly increased 30-day mortality, with an adjusted hazard ratio = 3.40 (95% confidence interval 1.70 to 6.70) and 4.20 (95% confidence interval 1.30 to 13.30), respectively. Importantly, there was no tendency of 30-day mortality difference between VF before and during PPCI (p = 0.170). In patients with VF before or during PPCI who survived for at least 30 days, there was no increase in the long-term mortality. In conclusion, our data suggest that 30-day mortality is the same for patients with VF before PPCI compared with VF during PPCI, and the occurrence of VF before or during PPCI was associated with increased 30-day mortality but not with long-term mortality. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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