Correlations between Cardiovascular Risk Factors and Ventricular Arrhythmias Following Primary Percutaneous Coronary
Hamid Khederlou1, Seyede Vanoushe Azimi Pirsaraei2, Elaheh Rabbani3
1Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Ventricular arrhythmias (VAs) affect about half of patients after heart attack treatment. Male gender and no prior PCI or CABG history increase VA risk, suggesting preventative antiarrhythmic drug use.
Area of Science:
- Cardiology
- Clinical Medicine
- Cardiac Electrophysiology
Background:
- Ventricular arrhythmias (VAs) are critical complications following acute myocardial infarction (MI) and revascularization procedures.
- These arrhythmias represent a significant, yet preventable, cause of sudden cardiac death.
- Understanding VA incidence and risk factors in ST-elevation MI (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) is crucial for improving outcomes.
Purpose of the Study:
- To investigate the incidence and types of ventricular arrhythmias (VAs) in patients with ST-elevation myocardial infarction (STEMI).
- To identify risk factors associated with the occurrence of VAs in patients undergoing primary percutaneous coronary intervention (PCI).
Main Methods:
- A cross-sectional study was conducted involving 315 patients admitted to a tertiary care cardiac center.
- Patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) were monitored during hospitalization.
- Data on cardiac arrhythmias and clinical outcomes were systematically recorded.
Main Results:
- Over half (50.5%) of the patients experienced VAs, with sustained ventricular tachycardia (VT) and ventricular fibrillation (VF) accounting for 26.4%.
- Male gender was significantly associated with VA occurrence (P=0.038).
- A history of prior percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) was linked to a significant reduction in arrhythmias (P=0.017 and P=0.013, respectively).
Conclusions:
- Reperfusion-induced VAs occurred in approximately half of the studied patients.
- Male gender and a lack of prior PCI or CABG history were significant predictors of VA occurrence.
- Prophylactic antiarrhythmic drug administration is recommended for males and patients without a history of PCI or CABG to mitigate VA risk.
Background:
Ventricular arrhythmias (VAs), which result from acute myocardial infarction and revascularization, are preventable causes of sudden cardiac death. This study aimed to determine the incidence, types, and risk factors of VAs in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI).
Methods:
This cross-sectional study was conducted at the cardiology department of a tertiary care cardiac center in Zanjan, Iran. All the patients were monitored during hospitalization, and the incidence of cardiac arrhythmias and the outcomes were recorded.
Results:
Among 315 patients, the mean age was 62.14±10.11 years, and 76.2% were male. Male gender was significantly associated with VA occurrence (P=0.038). Among the patients, 50.5% had VAs, of which 26.4% were sustained ventricular tachycardia (sustained VT) and ventricular fibrillation (VF). Sustained VT and VF, but not total arrhythmias, were more common in anterior infarctions. Most arrhythmias occurred during the first 12 hours, and frequent premature ventricular contractions (43.3%) and idioventricular rhythm (20.1%) were the most common. A history of PCI and coronary artery bypass grafting (CABG) was associated with substantially reduced arrhythmias (P=0.017 and P=0.013, respectively). However, cardiovascular risk factors exerted no statistically significant effects on the VA type.
Conclusion:
Approximately half of our patients experienced reperfusion-induced VAs. Overall, gender and a history of PCI and CABG were significantly associated with VA occurrence. Therefore, males and patients without a positive history of PCI and CABG should receive antiarrhythmic drugs as a precaution.
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