In-Hospital Outcomes of ST-Segment Elevation Myocardial Infarction Patients Presenting with Sustained Ventricular Arrhythmias before Revascularization
Irfan Ali, Ashok Kumar, Naveed Ahmed Shaikh, Muhammad Adeel Qamar, Amjad Ali, Rajesh Kumar
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ABSTRACT
Objective: To determine the
in-hospital outcomes after primary percutaneous coronary intervention (PCI) of
patients with acute ST-segment elevation myocardial infarction (STEMI) and
develop sustained ventricular arrhythmia before revascularization.
Methodology: This prospective
observational study was conducted at the Department of Adult Cardiology,
National Institute of Cardiovascular Diseases, from August 31, 2019, to
February 29, 2020. All patients with STEMI who had developed sustained
ventricular arrhythmias and underwent revascularization via primary PCI were
included. The patients were kept under observation during their hospital stay
to document in-hospital mortality. Data analysis was done using SPSS version
20.
Results: Total 146 patients were
included with a mean age of 54.41±12.75 years. There were 93 (63.7%) males and
53 (36.3%) females. When risk factors were assessed, hypertension was
noted in 82 (56.2%) patients, diabetes mellitus in 62 (42.5%), 65 (44.5%) were
smokers., and 49 (33.6%) were obese. There were 53 (36.3%) patients with a
family history of ischemic heart disease. In-hospital mortality was documented
in 28 (19.2%) patients. When stratification was done, significant associations
were seen with hypertension (p=0.025), diabetes mellitus (p=0.002), and family
history (p=0.003).
Conclusion: It is to be concluded that
mortality is considerably high after PCI in patients with STEMI who developed
sustained ventricular arrhythmia before revascularization. Obesity, family
history, and diabetes contribute directly to the development of MI. More
epidemiological studies are necessary to evaluate risk factors of in-hospital
mortality in this already compromised group of patients
Keywords: Revascularization, Myocardial Infarction, Sustained Ventricular
Arrhythmias, ST-Segment