title: Factors Associated With and Outcomes After Ventricular Fibrillation Before and During Primary Angioplasty in Patients With ST-Segment Elevation Myocardial Infarction.
abstract: We aimed to assess the risk factors and outcome of ventricular fibrillation (VF) before and during primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction. From 1999 to 2012, we consecutively enrolled 5,373 patients with ST-segment elevation myocardial infarction. In total, 410 of the patients had VF before and 88 had VF during PPCI. During a mean follow-up of 4.2 years, 1,196 subjects died. A logistic regression model identified younger age, anterior infarct, Killip class >I at admission, and a preprocedural Thrombolysis In Myocardial Infarction flow grade of 0 to I to be significantly associated with VF before PPCI, whereas inferior infarct, a preprocedural Thrombolysis In Myocardial Infarction flow grade of 0 to I, and Killip class >I at admission were significantly associated with VF during PPCI. All-cause mortality was evaluated using the Cox regression model. Compared with the patients without VF, those with VF before or during PPCI had a significantly increased 30-day mortality, with an adjusted hazard ratio = 3.40 (95% confidence interval 1.70 to 6.70) and 4.20 (95% confidence interval 1.30 to 13.30), respectively. Importantly, there was no tendency of 30-day mortality difference between VF before and during PPCI (p = 0.170). In patients with VF before or during PPCI who survived for at least 30 days, there was no increase in the long-term mortality. In conclusion, our data suggest that 30-day mortality is the same for patients with VF before PPCI compared with VF during PPCI, and the occurrence of VF before or during PPCI was associated with increased 30-day mortality but not with long-term mortality.
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory of Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet. Electronic address: rezajabbari77@gmail.com.
authors.forename: Reza
authors.initials: R
authors.lastname: Jabbari
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory of Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet.
authors.forename: Bjarke
authors.initials: B
authors.lastname: Risgaard
authors.affiliation: Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet.
authors.forename: Emil L
authors.initials: EL
authors.lastname: Fosbøl
authors.affiliation: Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Scheike
authors.affiliation: Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet.
authors.forename: Berit T
authors.initials: BT
authors.lastname: Philbert
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory of Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet.
authors.forename: Bo G
authors.initials: BG
authors.lastname: Winkel
authors.affiliation: Center for Arrhythmia Prevention, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Albert
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory of Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Glinge
authors.affiliation: Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet.
authors.forename: Kiril A
authors.initials: KA
authors.lastname: Ahtarovski
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory of Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet; Department of Medicine and Surgery, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Stig
authors.initials: S
authors.lastname: Haunsø
authors.affiliation: Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet; Department of Medicine and Surgery, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.affiliation: Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet.
authors.forename: Erik
authors.initials: E
authors.lastname: Jørgensen
authors.affiliation: Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet.
authors.forename: Frants
authors.initials: F
authors.lastname: Pedersen
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory of Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet; Department of Medicine and Surgery, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Tfelt-Hansen
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory of Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet.
authors.forename: Thomas
authors.initials: T
authors.lastname: Engstrøm
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002423:Cause of Death / Q000639:trends; D003718:Denmark / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*