title: Clinical Impact of Ventricular Tachycardia and/or Fibrillation During the Acute Phase of Acute Myocardial Infarction on In-Hospital and 5-Year Mortality Rates in the Percutaneous Coronary Intervention Era.
abstract: BACKGROUND
  The aim of this study was to investigate the prognostic impact of acute-phase ventricular tachycardia and fibrillation (VT/VF) on ST-segment elevation myocardial infarction (STEMI) patients in the percutaneous coronary intervention (PCI) era.
  
  
  RESULTS
  Using the database of the Osaka Acute Coronary Insufficiency Study (OACIS), we studied 4,283 consecutive patients with STEMI who were hospitalized within 12 h of STEMI onset and underwent emergency PCI. Acute-phase VT/VF, defined as ≥3 consecutive ventricular premature complexes and/or VF within the 1st week of hospitalization, occurred in 997 (23.3%) patients. In-hospital mortality risk was significantly higher in patients with acute-phase VT/VF than inthose without (14.6% vs. 4.3%, adjusted hazard ratio (HR) 1.83, P=0.0013). Among patients discharged alive, 5-year mortality rates were comparable between patients with and without acute-phase VT/VF. Subgroup analysis showed that acute-phase VT/VF was associated with increased 5-year mortality after discharge in high-risk patients (GRACE Risk Score ≥115; adjusted HR 1.60, P=0.043), but not in intermediate- or low-risk patients.
  
  
  CONCLUSIONS
  Even in the PCI era, acute-phase VT/VF was associated with higher in-hospital deaths of STEMI patients. However, the 5-year prognostic impact of acute-phase VT/VF was limited to high-risk patients. (Circ J 2016; 80: 1539-1547).
authors.affiliation: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Masuda
authors.forename: Daisaku
authors.initials: D
authors.lastname: Nakatani
authors.forename: Shungo
authors.initials: S
authors.lastname: Hikoso
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Suna
authors.forename: Masaya
authors.initials: M
authors.lastname: Usami
authors.forename: Sen
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Tetsuhisa
authors.initials: T
authors.lastname: Kitamura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Minamiguchi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Okuyama
authors.forename: Masaaki
authors.initials: M
authors.lastname: Uematsu
authors.forename: Takahisa
authors.initials: T
authors.lastname: Yamada
authors.forename: Katsuomi
authors.initials: K
authors.lastname: Iwakura
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Hamasaki
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sakata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sato
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nanto
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Hori
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sakata
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D015996:Survival Rate; D013610:Tachycardia / Q000401:mortality / Q000503:physiopathology / Q000601:surgery