title: Ventricular fibrillation in acute myocardial infarction in Spanish patients: Results of the ARIAM database.
abstract: OBJECTIVE
  The aim of this study has been to investigate the factors predisposing to primary or secondary ventricular fibrillation (VF) and the prognosis in Spanish patients with acute myocardial infarction (AMI) during their admission to the intensive care unit or the coronary care unit.
  
  
  METHODS
  A retrospective, observational study.
  
  
  METHODS
  The intensive care units and coronary care units of 119 Spanish hospitals.
  
  
  METHODS
  A retrospective cohort study including all the AMI patients listed in the ARIAM registry (Analysis of Delay in Acute Myocardial Infarction), a Spanish multicenter study. The study period was January 1995 to January 2001.
  
  
  RESULTS
  Factors associated with the onset of VF were studied by univariate analysis. Multivariate analysis was used to evaluate the independent factors for the onset of VF and for mortality. A total of 17,761 patients with AMI were included in the study; 964 (5.4%) developed VF (primary in 735 patients, secondary in 229). In multivariate analysis, the variables that continued to show an association with the development of VF were the Killip and Kimball class, peak creatine kinase, APACHE II score, age, and time from the onset of symptoms to the initiation of thrombolysis. The mortality in the patients with any VF was 31.8% (27.8% in patients with primary VF and 49.1% in patients with secondary VF). The development of VF is an independent predictive factor for mortality in patients with AMI, with a crude odds ratio of 5.12 (95% confidence interval, 4.41-5.95) and an adjusted odds ratio of 2.73 (95% confidence interval, 2.12-3.51).
  
  
  CONCLUSIONS
  Despite the considerable improvement in the treatment of AMI in recent years, the onset of either primary or secondary VF is associated with a poor prognosis. It is usually accompanied by extensive necrosis.
authors.affiliation: Critical Care and Emergency Department, Hospital de Poniente, El Ejido, Almeria, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Ruiz-Bailén
authors.forename: Eduardo
authors.initials: E
authors.lastname: Aguayo de Hoyos
authors.forename: Silvia
authors.initials: S
authors.lastname: Ruiz-Navarro
authors.forename: Ziad
authors.initials: Z
authors.lastname: Issa-Khozouz
authors.forename: Antonio
authors.initials: A
authors.lastname: Reina-Toral
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Díaz-Castellanos
authors.forename: Juan-José
authors.initials: JJ
authors.lastname: Rodríguez-García
authors.forename: Juan Miguel
authors.initials: JM
authors.lastname: Torres-Ruiz
authors.forename: Antonio
authors.initials: A
authors.lastname: Cárdenas-Cruz
authors.forename: Angel
authors.initials: A
authors.lastname: Camacho-Víctor
mesh_terms: D018806:APACHE; D000368:Aged; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008499:Medical Records; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications* / Q000473:pathology; D016017:Odds Ratio; D010343:Patient Admission; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D014693:Ventricular Fibrillation / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality