title: Outcome of contemporary acute coronary syndrome complicated by ventricular tachyarrhythmias.
abstract: OBJECTIVE
  To evaluate the incidence and prognostic implications of ventricular tachyarrhythmias (VTAs) complicating acute myocardial infarction (MI).
  
  
  RESULTS
  We evaluated 7669 MI patients [ST elevation (n = 3573) and non-ST-elevation acute coronary syndrome (ACS) (n = 4096)] from the Acute Coronary Syndrome Israeli Survey for the incidence of VTA. Ventricular tachyarrhythmia occurred in 3.8% of patients [2.1% early (≤ 48 h) and 1.7% late (>48 h) VTA]. In-hospital mortality rates were higher for patients with VTA when compared with patients with no VTA (P < 0.001). Consistent with these findings, multivariable analysis demonstrated that early and late VTAs were associated with increased risk of in-hospital death [hazard ratio (HR) = 3.84; 95% confidence interval (CI) 1.77-6.78, P < 0.001, and HR = 8.23; 95% CI 4.84-13.98, P < 0.001, respectively]. In contrast, post-discharge outcomes demonstrated that only late VTA was independently associated with a significant increased risk of 30-day mortality (HR = 5.17; 95% CI 1.54-17.27, P = 0.007) with a trend towards an increased 1-year mortality risk (HR = 1.69; 95% CI 0.79-3.62, P = 0.17). The long-term risk associated with in-hospital VTA was driven by sustained ventricular tachycardia (VT) (HR = 3.28; 95% CI 1.92-5.60, P < 0.001) but not ventricular fibrillation (HR = 1.27; 95% CI 0.65-2.49, P = 0.47).
  
  
  CONCLUSIONS
  Our findings suggest that in patients with ACS, both early and late VTAs are associated with an increased risk of in-hospital mortality. However, only late VTA, mostly sustained VT, is associated with long-term adverse outcome.
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinsky St. 49100, Petach Tikva, Tel Aviv, Israel katiaorvin@gmail.com.
authors.forename: Katia
authors.initials: K
authors.lastname: Orvin
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinsky St. 49100, Petach Tikva, Tel Aviv, Israel.
authors.forename: Alon
authors.initials: A
authors.lastname: Eisen
authors.affiliation: Neufeld Cardiac Research Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ilan
authors.initials: I
authors.lastname: Goldenberg
authors.affiliation: Neufeld Cardiac Research Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shmuel
authors.initials: S
authors.lastname: Gottlieb
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinsky St. 49100, Petach Tikva, Tel Aviv, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
authors.affiliation: Neufeld Cardiac Research Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shlomi
authors.initials: S
authors.lastname: Matetzky
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinsky St. 49100, Petach Tikva, Tel Aviv, Israel.
authors.forename: Gregory
authors.initials: G
authors.lastname: Golovchiner
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinsky St. 49100, Petach Tikva, Tel Aviv, Israel.
authors.forename: Jairo
authors.initials: J
authors.lastname: Kuznietz
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinsky St. 49100, Petach Tikva, Tel Aviv, Israel.
authors.forename: Natalie
authors.initials: N
authors.lastname: Gavrielov-Yusim
authors.affiliation: Neufeld Cardiac Research Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Amit
authors.initials: A
authors.lastname: Segev
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinsky St. 49100, Petach Tikva, Tel Aviv, Israel.
authors.forename: Boris
authors.initials: B
authors.lastname: Strasberg
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, 39 Jabotinsky St. 49100, Petach Tikva, Tel Aviv, Israel.
authors.forename: Moti
authors.initials: M
authors.lastname: Haim
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D000368:Aged; D005260:Female; D006306:Health Surveys; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy
keywords: ACSIS registry; Acute coronary syndrome; Acute myocardial infarction; Outcome; Ventricular fibrillation; Ventricular tachycardia