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Prognostic significance of ventricular arrhythmias in 13444 patients with acute coronary syndrome: a retrospective cohort study based on routine clinical data (NIHR Health Informatics Collaborative VA-ACS Study)

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Title: Prognostic significance of ventricular arrhythmias in 13444 patients with acute coronary syndrome: a retrospective cohort study based on routine clinical data (NIHR Health Informatics Collaborative VA-ACS Study)
Authors: Sau, A
Kaura, A
Ahmed, A
Patel, KHK
Li, X
Mulla, A
Glampson, B
Panoulas, V
Davies, J
Woods, K
Gautama, S
Shah, AD
Elliott, P
Hemingway, H
Williams, B
Asselbergs, FW
Melikian, N
Peters, NS
Shah, AM
Perera, D
Kharbanda, R
Patel, RS
Channon, KM
Mayet, J
Ng, FS
Item Type: Journal Article
Abstract: Background: A minority of acute coronary syndrome (ACS) cases are associated with ventricular arrhythmias (VA) and/or cardiac arrest (CA). We investigated the effect of VA/CA at time of ACS on long-term outcomes. Methods and Results: We analysed routine clinical data from 5 NHS Trusts in the United Kingdom, collected between 2010 and 2017, by the National Institute for Health Research Health Informatics Collaborative (NIHR HIC). 13,444 patients with ACS, of which 376 (2.8%) had concurrent VA, survived to hospital discharge and were followed up for a median of 3.42 years. Patients with VA or CA at index presentation had significantly increased risks of subsequent VA during follow-up (VA group: adjusted HR 4.15, 95% CI 2.42-7.09, CA group: adjusted HR 2.60 95% CI 1.23-5.48). Patients who suffered a CA in the context of ACS and survived to discharge also had a 36% increase in long-term mortality (adjusted hazard ratio 1.36 (95% 1.04-1.78)), though the concurrent diagnosis of VA alone during ACS did not affect all-cause mortality (adjusted HR 1.03, 95% CI 0.80-1.33). Conclusions: Patients who develop VA or CA during ACS, who survive to discharge, have increased risks of subsequent VA, while those who have CA during ACS also have an increase in long-term mortality. These individuals may represent a subgroup at greater risk of subsequent arrhythmic events due to intrinsically lower thresholds for developing VA.
Issue Date: 15-Mar-2022
Date of Acceptance: 6-Jan-2022
URI: http://hdl.handle.net/10044/1/94249
DOI: 10.1161/JAHA.121.024260
ISSN: 2047-9980
Publisher: Wiley
Start Page: 1
End Page: 19
Journal / Book Title: Journal of the American Heart Association
Volume: 11
Issue: 6
Copyright Statement: © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
Sponsor/Funder: British Heart Foundation
British Heart Foundation
British Heart Foundation
British Heart Foundation
British Heart Foundation
Health Data Research Uk
Imperial College Healthcare NHS Trust- BRC Funding
Funder's Grant Number: PG/16/17/32069
PG/16/17/32069
RG/16/3/32175
FS/20/18/34972
FS/CRTF/21/24183
Health Data Research UK
RDF03
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
acute coronary syndrome
cardiac arrest
ventricular arrhythmia
ST-SEGMENT-ELEVATION
ACUTE MYOCARDIAL-INFARCTION
IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR
SUDDEN CARDIAC DEATH
EUROPEAN-SOCIETY
TASK-FORCE
FIBRILLATION
TACHYCARDIA
MANAGEMENT
OUTCOMES
acute coronary syndrome
cardiac arrest
ventricular arrhythmia
1102 Cardiorespiratory Medicine and Haematology
Publication Status: Published
Online Publication Date: 2022-03-08
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine
School of Public Health



This item is licensed under a Creative Commons License Creative Commons