Background: The prognostic implication of early ventricular tachyarrhythmias (VTs) after acute coronary syndrome (ACS) remains unclear.
Objective: We sought to investigate the clinical outcomes of early monomorphic and non-monomorphic VTs that occur within 48 hours in patients after ACS.
Methods: We retrospectively reviewed the clinical outcomes of 2033 [mean age 67.0 ± 13.4 years; 1486 (73.1%) men] consecutive patients who presented with ACS from 2004 to 2015.
Results: A total of 67 (3.3%) and 90 (4.4%) patients developed early monomorphic or non-monomorphic VT, respectively. Killip class IV (odds ratio [OR] 3.05; 95% confidence interval [CI] 1.47-6.36; P < .01), creatine kinase level (OR 1.01; 95% CI 1.00-1.02 per 100 IU/L; P = .01), and left ventricular ejection fraction (OR 0.96; 95% CI 0.94-0.99; P < .01) were independently associated with early monomorphic VT, whereas age (OR 0.98; 95% CI 0.97-0.99; P = .04), ST elevated myocardial infarction (OR 3.53; 95% CI 1.71-7.27; P < .01), Killip class IV (OR 4.91; 95% CI 2.76-8.74; P < .01), diabetes mellitus (OR 0.48; 95% CI 0.28-0.81; P < .01), and left ventricular ejection fraction (OR 0.97; 95% CI 0.95-0.99; P < .01) were independently associated with early non-monomorphic VT. More patients with early monomorphic VT (n = 22 [32.8%]) died in hospital than those with non-monomorphic VT (n = 16 [17.8%]) or without early VT (n = 133 [7.1%]; P < .01). After a mean follow-up of 67.8 ± 43.2 months, 21 patients with early monomorphic VT (46.7%), 22 patients with early non-monomorphic VT (29.7%), and 552 patients without early VT (31.7%) died. Both early monomorphic and non-monomorphic VTs were associated with a long-term increase in sudden arrhythmic deaths and recurrent VTs. Nevertheless, only early monomorphic VT was shown to independently predict overall survival (hazard ratio 1.62; 95% CI 1.03-2.55; P = .04).
Conclusion: Early monomorphic VT, but not early non-monomorphic VT, independently predicted all-cause mortality in patients with ACS who survived to hospital discharge.
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http://dx.doi.org/10.1016/j.hrthm.2018.02.016 | DOI Listing |
Front Immunol
November 2024
Department of Urology, The General Hospital of Western Theater Command, Chengdu, China.
Background: Kidney transplantation (KT) is the best treatment for patients with end-stage renal disease. However, postoperative complications remain the main issues faced during KT recovery period. Posttransplant lymphoproliferative disorders (PTLD) are one of the severe and life-threatening complications that occur after KT while the recipient is undergoing immunosuppressive therapy.
View Article and Find Full Text PDFInt J Surg Case Rep
November 2024
Department of surgery, Cardinal Tien hospital, New Taipei City, Taiwan.
Introduction And Importance: Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a rare and aggressive T-cell lymphoma that primarily affects the intestine. It has a poor prognosis and high mortality rate. Symptoms at presentation can be non-specific, and imaging studies may show similarities with nonmalignant conditions.
View Article and Find Full Text PDFJ Transl Med
October 2024
Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Singapore, Singapore.
Cardiooncology
October 2024
Memorial Sloan Kettering Cancer Center | Weill Cornell Medicine, 1275 York Ave, New York, NY, 10065, USA.
Background: Trabectedin (Tbt) is an alkylating agent prescribed for soft tissue sarcomas after treatment failure of first line agents. While cardiomyopathy can occur with Tbt treatment after anthracycline exposure, Tbt-induced fulminant myocardial cytotoxic injury in the setting of other systemic cytotoxicity associated with Tbt has not been reported.
Case Presentation: 51-year-old female with hypertension, hyperlipidemia, metastatic leiomyosarcoma with progression of disease despite several lines of chemotherapy including doxorubicin-based therapy was started on Trabectedin (Tbt) 5 days prior to presentation with symptoms of fever, myalgias, arthralgias, and palpitations.
Int J Surg Case Rep
November 2024
Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania; Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Kilimanjaro Clinical Research Institute, Moshi, Tanzania. Electronic address:
Introduction And Importance: Basal cell adenoma (BCA) is a rare, benign tumor of the salivary gland. It has distinct histologic features that are different from mixed tumors of the salivary gland. Often times, it occurs in the parotid gland.
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