Incidence of ventricular arrhythmia and associated patient outcomes in hospitalized acute coronary syndrome patients in Saudi  Arabia: findings from the registry of the Saudi Project for Assessment of Acute Coronary Syndrome (SPACE).
OBJECTIVE
Mortality in acute coronary syndrome (ACS) patients with ventricular arrhythmia (VA) has been shown to be higher than those without VA. However, there is a paucity of data on VA among ACS patients in the Middle Eastern countries.


METHODS
Prospective study of patients admitted in 17 government hospitals with ACS between December 2005 and December 2007.


METHODS
Patients were categorized as having VA if they experienced either ventricular fibrillation (VF) or sustained ventricular tachycardia (VT) or both.


RESULTS
Of 5055 patients with ACS enrolled in the SPACE registry, 168 (3.3%) were diagnosed with VA and 151 (98.8%) occurred in-hospital. The vast majority (74.4%) occurred in patients with ST-segment elevation myocardial infarction. In addition, males were twice as likely to develop VA than females (OR 1.7; 95% CI 1.13). Killip class >I (OR 2.0; 95% CI 1.3-3.1); and systolic blood pressure <90 mm Hg (OR 6.4; 95% CI 3.5-11.8) were positively associated with VA. Those admitted with hyperlipidemia (OR 0.49; 95% CI 0.3-0.7) had a lower risk of developing VA. Adverse in-hospital outcomes including re-myocardial infarction, cardiogenic shock, congestive heart failure, major bleeding, and stroke were higher for patients with VA (P≤.01 for all variables) and signified a poor prognosis. The in-hospital mortality rate was significantly higher in VA patients compared with non-VA patients (27% vs 2.2%; P=.001).


CONCLUSIONS
In-hospital VA in Saudi patients with ACS was associated with remarkably high rates of adverse events and increased in-hospital mortality. Using a well-developed registry data with a large number of patients, our study documented for the first time the prevalence and risk factors of VA in unselected population of ACS.
Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia. ahersi@ksu.edu.sa
Ahmad S
AS
Hersi
Khalid F
KF
Alhabib
Hussam F
HF
AlFaleh
Khalid
K
AlNemer
Shukri
S
AlSaif
Amir
A
Taraben
Tarek
T
Kashour
Ahmed M
AM
Abuosa
Mushabab A
MA
Al-Murayeh
D054058:Acute Coronary Syndrome / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006779:Hospitals, Public; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012737:Sex Factors; D017180:Tachycardia, Ventricular / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology*; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology*