Cardiac arrhythmias in Thai Acute Coronary Syndrome Registry
Tachapong Ngarmukos1, Charn Sriratanasthavorn, Buncha Sansaneevithayakul
1Cardiovascular Disease Section, Department of Internal Medicine, Ramathibodi Hospital, Mahidol Univertsity, Bangkok 10400, Thailand. tetng@mahidol.ac.th
Insights
Arrhythmia complications in Thai acute coronary syndrome (ACS) patients occurred in 16.6%, increasing mortality risk. Congestive heart failure, tobacco use, and troponin levels were key associated factors.
Area of Science:
- Cardiology
- Clinical Research
- Public Health
Background:
- The incidence of arrhythmic complications in Thai patients with acute coronary syndromes (ACS) was previously unreported.
- This study establishes a local database for future research on ACS complications in Thailand.
Purpose of the Study:
- To determine the incidence of arrhythmic complications in Thai patients experiencing ACS.
- To identify factors influencing arrhythmia development in ACS patients.
Main Methods:
- Analysis of data from 9,373 patients in the Thai Acute Coronary Syndrome Registry (TACSR).
- Inclusion criteria: patients presenting with ACS (STEMI, NSTEMI, UA) within 14 days of symptom onset.
Main Results:
- 16.6% of ACS patients experienced serious cardiac arrhythmia complications.
- Sustained ventricular tachycardia/fibrillation (VT/VF) occurred in 62.7%, and second/third-degree AV block in 31.5%.
- Congestive heart failure (CHF) within 48 hours, current tobacco use, and elevated cardiac troponin were linked to higher arrhythmia incidence.
Conclusions:
- Arrhythmias significantly increase in-hospital mortality for ACS patients.
- Early CHF, tobacco use, and elevated troponin are critical predictors of arrhythmic complications in ACS.
Background:
The incidence of arrhythmic complications in Thai patients with acute coronary syndromes (ACS) has not been previously reported. The present study results will serve as the local database for future studies.
Objective:
To evaluate the incidence of arrhythmic complications in ASC in Thai patients and to identify factors that may affect arrhythmia complications in ACS patients.
Material And Method:
Data collected from 9,373 patients from the Thai acute coronary syndrome registry (TACSR) were analyzed. This registry includes patients who presented with ACS including ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA), within 14 days from the symptoms onset.
Results:
395 (4.2%) patients with an ACS presented after cardiac arrest. These patients were noted to have significantly higher in-hospital mortality (50.1%). The incidence of serious cardiac arrhythmia complications in the TACSR was 16.6%. Among them, 62.7% were sustained VT/VE 31.5% had second or third degree AV block, and 5.8% has both VT/VF and AV Block. The incidence of VT was higher in the younger age group, while AV block and arrhythmic death were higher in the older aged patients. Arrhythmias complicating ACS were associated with increased mortality risk. Congestive heart failure (CHF) within the first 48 hours, current use of tobacco and cardiac troponin elevation were associated with significantly higher arrhythmic complications during hospitalization.
Conclusion:
Arrhythmias complicating ACS were associated with higher in hospital mortality. CHF within the first 48 hr, current tobacco use and cardiac troponin elevation were associated with significantly higher arrhythmic complications.
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