title: Incidence, prognosis, and factors associated with cardiac arrest in patients hospitalized with acute coronary syndromes (the Global Registry of Acute Coronary Events Registry).
abstract: OBJECTIVE
  Contemporary data are lacking with respect to the incidence rates of, factors associated with, and impact of cardiac arrest from ventricular fibrillation or tachycardia (VF-CA) on hospital survival in patients admitted with an acute coronary syndrome (ACS). The objectives of this multinational study were to characterize trends in the magnitude of in-hospital VF-CA complicating an ACS and to describe its impact over time on hospital prognosis.
  
  
  METHODS
  In 59 161 patients enrolled in the Global Registry of Acute Coronary Events Study between 2000 and 2007, we determined the incidence, prognosis, and factors associated with VF-CA.
  
  
  RESULTS
  Overall, 3618 patients (6.2%) developed VF-CA during their hospitalization for an ACS. Incidence rates of VF-CA declined over time. Patients who experienced VF-CA were on average older and had a greater burden of cardiovascular disease, yet were less likely to receive evidence-based cardiac therapies than patients in whom VF-CA did not occur. Hospital death rates were 55.3% and 1.5% in patients with and without VF-CA, respectively. There was a greater than 50% decline in the hospital death rates associated with VF-CA during the years under study. Patients with a VF-CA occurring after 48 h were at especially high risk for dying during hospitalization (82.8%).
  
  
  CONCLUSIONS
  Despite reductions in the magnitude of, and short-term mortality from, VF-CA, VF-CA continues to exert an adverse effect on survival among patients hospitalized with an ACS. Opportunities exist to improve the identification and treatment of ACS patients at risk for VF-CA to reduce the incidence of, and mortality from, this serious arrhythmic disturbance.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA.
authors.forename: David D
authors.initials: DD
authors.lastname: McManus
authors.forename: Farhan
authors.initials: F
authors.lastname: Aslam
authors.forename: Parag
authors.initials: P
authors.lastname: Goyal
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Goldberg
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gore
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000628:therapy; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D014943:Global Health; D006323:Heart Arrest / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors