Date

4-29-2012

UMMS Affiliation

Graduate School of Biomedical Sciences, Master of Science in Clinical Investigation (MSCI) program

Document Type

Thesis, Master's

Subjects

Theses, UMMS; Acute Coronary Syndrome; Heart Arrest; Ventricular Fibrillation; Tachycardia

Disciplines

Cardiovascular Diseases | Health Services Research | Life Sciences | Medicine and Health Sciences

Abstract

Objectives: Contemporary data are lacking with respect to the incidence rates of, factors associated with, and impact of cardiac arrest from ventricular fibrillation or tachycardia (VF-CA) on hospital survival in patients admitted with an acute coronary syndrome (ACS). The objectives of this multinational study were to characterize trends in the magnitude of in-hospital VF-CA complicating an ACS and describe its impact over time on hospital prognosis.

Methods: The study population consisted of 59,161 patients enrolled in the Global Registry of Acute Coronary Events Study between 2000 and 2007. Overall, 3,618 patients (6.2%) developed VF-CA during their hospitalization for an ACS. Incidence rates of VF-CA declined over time, albeit in an inconsistent manner. Patients who experienced VF-CA were on average older and had a greater burden of cardiovascular disease, yet were less likely to receive evidence-based cardiac therapies than patients in whom VF-CA did not occur. Hospital death rates were 55.3% and 1.5% in patients with and without VF-CA, respectively. There was a greater than 50% decline in the hospital death rates associated with VF-CA during the years under study. Patients with a VF-CA occurring after 48 hours were at especially high risk for dying during hospitalization (82.8%).

Conclusions: Despite reductions in the magnitude of, and short-term mortality from, VF-CA between 2000 and 2007, VF-CA continues to exert a significant adverse effect on survival among patients hospitalized with an ACS. Opportunities exist to improve the identification and treatment of ACS patients at risk for VF-CA to reduce the incidence of, and mortality from, this serious arrhythmic disturbance.