Ventricular fibrillation in acute myocardial infarction in Spanish patients: Results of the ARIAM database.
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.
Ruiz-Bailén
Manuel
M
Critical Care and Emergency Department, Hospital de Poniente, El Ejido, Almeria, Spain.
Aguayo de Hoyos
Eduardo
E
Ruiz-Navarro
Silvia
S
Issa-Khozouz
Ziad
Z
Reina-Toral
Antonio
A
Díaz-Castellanos
Miguel Angel
MA
Rodríguez-García
Juan-José
JJ
Torres-Ruiz
Juan Miguel
JM
Cárdenas-Cruz
Antonio
A
Camacho-Víctor
Angel
A
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