Short-term and long-term mortality associated with ventricular arrhythmia in patients hospitalized with acute coronary syndrome:  findings from the Gulf RACE registry-2.
OBJECTIVE
Ventricular arrhythmia (VA) in the setting of acute coronary syndrome (ACS) carries an ominous prognosis; however, long-term prognosis associated with VA in ACS in the Middle East is unknown. Accordingly, we sought to assess the incidence, in-hospital outcomes, and 1-year mortality of in-hospital VA in patients with ACS.


RESULTS
The Second Gulf Registry of Acute Coronary Events (Gulf RACE-2) is a multinational observational study of patients with ACS, which enrolled 7930 patients. Of these, 333 (4.2%) developed VA during hospitalization. Patients with VA were significantly older (mean age 58.3 vs. 56.8 years), and had a significantly higher rate of prior stroke/transient ischemic attack (7.5 vs. 4.2%), smoking (36.6 vs. 35.6%), congestive heart failure (11.0 vs. 6.5%), and peripheral artery disease (6.5 vs. 1.7%), compared with patients without VA. They had significantly less diabetes mellitus (35.4 vs. 40.3%), hypertension (43.2 vs. 47.9%), percutaneous coronary intervention (6.1 vs. 9.4%), and dyslipidemia (22.4 vs. 38.2%). The adjusted odds ratios for in-hospital, 30-day, and 1-year mortality in VA complicating all ACS were 25.8, 11.1, and 7.3; ST-elevation myocardial infarctions were 18.3, 11.7, and 6.3; and unstable angina and non-ST elevation myocardial infarctions were 47.4, 10.3, and 18.7, respectively (all P<0.001).


CONCLUSIONS
In-hospital VA in patients with ACS with and without ST elevation was associated with significantly higher in-hospital, 30-day, and 1-year mortality. Noticeably higher long-term mortality among Middle Eastern patients with ACS having VA compared with other reports requires further study and warrants immediate attention.
Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. ahersi@ksu.edu.sa
Ahmad
A
Hersi
Khalid F
KF
Alhabib
Alawi A
AA
Alsheikh-Ali
Kadhim
K
Sulaiman
Hussam F
HF
Alfaleh
Shukri
S
Alsaif
Wael
W
Al-Mahmeed
Nidal
N
Asaad
Haitham
H
Amin
Ahmed
A
Al-Motarreb
Jassim
J
Al Suwaidi
D054058:Acute Coronary Syndrome / Q000401:mortality* / Q000628:therapy; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000367:Age Factors; D000789:Angina, Unstable / Q000453:epidemiology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000401:mortality* / Q000628:therapy; D017023:Coronary Angiography / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology; D004363:Drug Utilization; D050171:Dyslipidemias / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000453:epidemiology; D002546:Ischemic Attack, Transient / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention / Q000706:statistics & numerical data; D058729:Peripheral Arterial Disease / Q000453:epidemiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012042:Registries; D012907:Smoking / Q000453:epidemiology
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors