PhD Scientific Days 2020

Clinical Medicine IV. Lectures

The Prognostic Significance of the Early Ventricular Fibrillation in Acute Myocardial Infarction Presenting with and without ST-Segment Elevation

Előadó neve

Dr. Skoda, Réka

Előadó munkahelye

The Heart and Vascular Center of Semmelweis University

Előadó telefonszáma

06206701711

Előadó e-mail címe

skodareka0824@gmail.com

Az előadás címe

The Prognostic Significance of the Early Ventricular Fibrillation in Acute Myocardial Infarction Presenting with and without ST-Segment Elevation

Szerző(k) neve és munkahelye

Skoda Réka 1, Bárczi György 1, Gajdácsi József 2, Vágó Hajnalka 1, Czimbalmos Csilla 1, Csécs Ibolya 1, Zima Endre 1, Heltai Krisztina 1, Édes István Ferenc 1, Ruzsa Zoltán 1, Dinya Elek 2, Merkely Béla 1, Becker Dávid 1
1 The Heart and Vascular Center of Semmelweis University
2 Semmelweis University

Szekció

Clinical Medicine IV. Lectures

Language of the presentation

English

Section, first choice

Clinical Medicine

Section, second choice

Clinical Medicine

Összefoglaló szövege

Introduction: The prognostic significance of an early ventricular fibrillation (EVF) due to acute coronary syndrome needs further investigation in both STEMI and NSTEMI populations. In our pilot study we found that EVF increases the 30-day mortality. Between 30 days and 1 year an additional worsening of mortality rate can be observed among NSTEMI patients.
The aim of our study was to extend our previous investigation about the factors influencing the prognosis of patients presenting with STEMI/NSTEMI after EVF and to compare the clinical characteristics of the VF and non-VF population.
Methods: In our retrospective study 12270 consecutive patients were investigated, among whom 547 were VF positive. 30-day and 1-year survival data were examined in patients who were admitted due to NSTEMI (n=6840) and STEMI (n=5430).
Results: Three-vessel coronary artery disease including LM involvement and PCI of more than one main vessel was associated with worse prognosis in STEMI patients only. Significant differences in 30-days and 1-year mortality could be demonstrated in patients with vs. without EVF (p<0.0001). A higher ratio of STEMI cases, diabetes, reduced ejection fraction and kidney function were found after EVF (p<0.0001). Among EVF positive cases the severity of the acute event (heart- and kidney failure, on-site CPR, cardiogenic shock, respiratory treatment) had a significant impact on the 30-day and 1-year mortality in patients with STEMI. The one-year mortality of cardiogenic shock patients proved to be extremely high in both STEMI and NSTEMI populations with EVF. In terms of survival NSTEMI compared to STEMI showed worse outcome after an EVF.
Conclusions. The presence of EVF worsens prognosis in patients initially surviving STEMI and NSTEMI. The present guidelines do not offer appropriate rules to select and treat these subjects. Further risk stratification may change the current guidelines regarding a better patient selection, among others who may benefit from early ICD implantations.

Additional Information

Supervisor: Becker Dávid
E-mail address: becker.david@kardio.sote.hu

Bemutatás módja

Szóbeli

Kind

Szabad

Status

elfogadva

Accepted presentation method

szóbeli

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

4677

Start

17:30

End

17:45

Authors (legacy)

Skoda Réka 1, Bárczi György 1, Gajdácsi József 2, Vágó Hajnalka 1, Czimbalmos Csilla 1, Csécs Ibolya 1, Zima Endre 1, Heltai Krisztina 1, Édes István Ferenc 1, Ruzsa Zoltán 1, Dinya Elek 2, Merkely Béla 1, Becker Dávid 1
1 The Heart and Vascular Center of Semmelweis University
2 Semmelweis University