title: Incidence and predictors of sudden arrhythmic death or ventricular tachyarrhythmias after acute coronary syndrome: An asian perspective.
abstract: Current data on the risk of sudden arrhythmic death (SAD) and ventricular tachyarrhythmias (VTs) after acute coronary syndrome (ACS) in the Asian population are limited.
  
  
  
  The purpose of this study was to investigate the incidence and predictors of SAD or VT after ACS in a contemporary cohort of Chinese patients in the era of early revascularization.
  
  
  
  Consecutive patients admitted to our unit for ACS from 2010 to 2015 were retrospectively reviewed.
  
  
  
  A total of 918 patients (74.8% male, mean age 65.9 ± 13.4 years) were included in the study. Of these patients, 864 (94.1%) survived to discharge. After a mean of 34.1 ± 21.8 months, 42 (4.9%) had SAD or VT. The event rate was 0.46% in month 1, 0.26% per month in the months 2 to 6, 0.15% per month in months 6 to 12, and 1.23% per year from the second year onward. In multivariate analysis, early VT (hazard ratio [HR] 5.78, 95% confidence interval [CI] 2.63-12.72, P < .01), left ventricular ejection fraction ≤35% (HR 1.96, 95% CI 1.03-3.73, P = .04), prior coronary artery disease (HR 2.50, 95% CI 1.29-4.82, P < .01), triple-vessel disease (HR 3.69, 95% CI 1.81-7.54, P < .01), and chronic kidney disease (HR 2.43, 95% CI 1.21-4.92, P = .01) independently predicted SAD or VT.
  
  
  
  This study reports the rate of SAD or VT among Asian patients after ACS in the era of early revascularization and optimal medical therapy. Aggressive preventive measures should be considered for patients with multiple risk factors for SAD or VT, especially in the initial period after ACS.
authors.affiliation: Cardiology Division, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China; Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Jo-Jo
authors.initials: JJ
authors.lastname: Hai
authors.affiliation: Cardiology Division, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Edward
authors.initials: E
authors.lastname: Tam
authors.affiliation: Cardiology Division, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China; Division of Cardiology, Department of Medicine, University of Hong Kong Shenzhen Hospital, Hong Kong SAR, China.
authors.forename: Pak-Hei
authors.initials: PH
authors.lastname: Chan
authors.affiliation: Cardiology Division, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Chu-Pak
authors.initials: CP
authors.lastname: Lau
authors.affiliation: Cardiology Division, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China; Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Chung-Wah
authors.initials: CW
authors.lastname: Siu
authors.affiliation: Cardiology Division, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China; Shenzhen Institutes of Research and Innovation, University of Hong Kong, Hong Kong SAR, China; Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Division of Cardiology, Department of Medicine, University of Hong Kong Shenzhen Hospital, Hong Kong SAR, China. Electronic address: hftse@hku.hk.
authors.forename: Hung-Fat
authors.initials: HF
authors.lastname: Tse
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality* / Q000628:therapy; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality* / Q000628:therapy; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality* / Q000628:therapy
keywords: Acute coronary syndrome; Asian; Sudden arrhythmic death; Ventricular tachycardia, Ventricular fibrillation