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ȣ - 510267 180 |
Prevalence and Prognosis of Ventricular Arrhythmia in Korean Patients with Acute Myocardial Infarction: Korean Acute Myocardial Infarction Registry
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Korea Acute Myocardial infarction Registry Investigators |
윤남식, 정명호, 안영근, 채성철, 김종현, 성인환, 김영조, 허승호, 최동훈, 홍택종, 윤정한, 류제영, 채제건, 김두일, 채인호, 구본권, 김병옥, 이내희, 황진용, 오석규, 조명찬, 김기식, 정경태, 이명용, 김종진, 정욱성, 장양수, 조정관, 승기배, 박승정 외 KAMIR 연구자 |
Background: It is known that a large myocardial infarction has correlation with high risk from serious post-infarction arrhythmia. Method: These reports are based on Korean Acute Myocardial Infarction Registry (KAMIR) data which were collected from Nov 2005 to Apr 2007. Study population had 10,740 patients (63.9±13.4 year-old, 6,789 males) with AMI. Results: 5,705 patients with STEMI (63.0±13.6 years, 4180 males) and 3,857 patients with NSTEMI (65.2±13.0 years, 2486 males) were registered, and 286 patients(2.7%, 64.0±14.1 year old, 203 males) were complicated with post-infarction ventricular tachycardia, 131 patients (1.2%, 65.3±12.5 year old, 90 males) were complicated with post-infarction ventricular fibrillation. Past medications had no preventive values of ventricular arrhythmia. In laboratory findings, troponin I (82.8±146.0 vs. 43.9±87.0, p<0.001), NT-proBNP (5312.9±8709.1 vs. 2862.8±6626.4, p=0.001) were higher and LDL-cholesterol (108.5±39.4 vs 117.6±47.0, p=0.004) was lower in patients with ventricular tachycardia. High sensitive-CRP was not different between patients with and without ventricular tachycardia. In coronary angiographic findings, pre-PCI TIMI flow was lower in patients with ventricular tachycardia (0.8±1.1 vs 1.3±1.2, p<0.001). Size and number of stent implanted had no correlation with ventricular tachycardia. There was higher prevalence of ventricular tachycardia (4.8% vs 2.9%, p=0.016) or fibrillation (2.1% vs 0.9%, p=0.018) in patients underwent primary PCI than patients underwent thrombolytic therapy. Ventricular tachycardia and ventricular fibrillation developed more frequently when the post-PCI TIMI flow was low(p=0.009) or when the successful PCI was not obtained(9.9% vs 2.7%, p<0.001). In-hospital mortality was high when a ventricular tachycardia occurred (33.9% vs 3.9%, p<0.001). However, one-month MACE was not increased despite ventricular tachycardia or fibrillation. Conclusion: Post-myocardial infarction ventricular tachycardia developed in 2.7% of AMI in Korea. Especially, it developed more frequently when successful PCI was not obtained. There was no relationship between ventricular tachycardia and one-month MACE.
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