Early monomorphic ventricular tachycardia tied to long-term mortality in STEMI: Study
Sweden: Early monomorphic ventricular tachycardia (VT) compared to nonmonomorphic VT/VF (ventricular fibrillation) is associated with a higher risk of all-cause mortality in STEMI patients, concludes a recent study. The study appears in The American Journal of Cardiology.
Early ventricular tachycardia and ventricular fibrillation are shown to be associated with increased in-hospital mortality but does not impact the long-term prognosis in ST-elevation myocardial infarction (STEMI). Recent data support a differential approach to the arrhythmia type and indicate long-term mortality hazard tied to monomorphic VT.
Against the above background, Marina M. Demidova, Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden, and colleagues aimed to evaluate the prognostic value of early monomorphic VT compared to nonmonomorphic VT/VF in a nonselected cohort of STEMI patients.
The study included consecutive STEMI patients admitted for primary percutaneous coronary intervention from 2007 to 2010. Using the Swedish national SWEDEHEART registry, clinical characteristics were obtained. The occurrence and type of early VT/VF were verified in medical records.
Swedish Cause of Death Register was used to assess all-cause mortality 8 years after STEMI. A total of 2,277 STEMI patients were included (age 66 ± 12 years, 70% male), among them 35 (1.5%) with early monomorphic VT and 115 (5.1%) with nonmonomorphic VT/VF.
Key findings include:
- Patients with monomorphic VT had similar clinical characteristics compared to those with nonmonomorphic VT/VF.
- In total, 22 patients (63%) with monomorphic VT and 43 (37%) with nonmonomorphic VT/VF died by 8 years of follow-up.
- Monomorphic VT was associated with a higher risk of all-cause mortality compared to nonmonomorphic VT/VF in univariate analysis (HR 2.03) and after adjustment for age and history of myocardial infarction (MI) (HR 1.74).
The researchers conclude, "early monomorphic VT versus nonmonomorphic VT/VF in STEMI is associated with a higher risk of all-cause mortality and deserves further studies to refine risk stratification strategies."
Reference:
The study titled, "Relation of Early Monomorphic Ventricular Tachycardia to Long-Term Mortality in ST-Elevation Myocardial Infarction," was published in The American Journal of Cardiology.
