Predicting Ventricular Arrhythmias and In-Hospital Mortality in Acute Coronary Syndrome Patients Presenting to the Emergency Department
1Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
2Cardiology Unit, Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
DOI: 10.22514/sv.2020.16.0008 Vol.16,Issue 1,June 2020 pp.55-64
Published: 30 June 2020
Background: Ventricular arrhythmias (VA) after acute coronary syndrome (ACS) is associated with a higher risk of mortality. This study sought to examine the incidence, predictors and outcome of VA in ACS patients. Material and methods: A prospective cross-sectional study was conducted at the emergency department (ED), Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in Kuala Lumpur, Malaysia. Patients with acute coronary syndrome (ST-segment elevation myocardial infarction [STEMI] and non-ST-segment elevation acute coronary syndrome [NSTEACS]) were continuously monitored for the occurrence of VA. Results: A total of 144 patients were recruited (67 STEMI and 77 NSTE-ACS). The total rate of VA was 18.8% (n = 27) and 14.6% (n = 21) experienced malignant ventricular arrhythmias (MVA) (8 ventricular fibrillation, 11 sustained ventricular tachycardia and 2 torsades de pointes). In-hospital mortality was reported in 11.1% of the subjects (n = 16). Factors predicted the occurrence of VA was Killip class IV (OR 8.67, 95% confidence interval [CI] 2.08-36.70, p < 0.05). Meanwhile, occurrence of MVA (OR 86.37, 95% CI 4.16 - 1792.70, p < 0.05) and blood sugar level (OR 1.30, 95% CI 1.01 - 1.67, p < 0.05) independently predicted in-hospital mortality. Conclusion: Incidence of VA was higher than the global estimate and the development of malignant forms of VA during hospitalization for ACS was associated with higher in-hospital mortalities.
Acute coronary syndrome, Risk factor, Arrhythmias, Emergency, Mortality
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