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Review
. 2022 Jul 15;101(28):e29685.
doi: 10.1097/MD.0000000000029685.

Impact of de novo tachyarrhythmias in patients with prior acute coronary syndrome

You Mi Hwang  1   2 , Min Kyung Sung  1 , Seon Ok Kim  3
Affiliations
Review

Impact of de novo tachyarrhythmias in patients with prior acute coronary syndrome

You Mi Hwang et al. Medicine (Baltimore). .

Abstract

Although the incidence of acute coronary syndrome (ACS) has increased over the decades, the overall prognosis has improved with newer stents, tailored medication, and better intervention techniques. Atrial fibrillation (AF) and ventricular arrhythmia at the time of ACS diagnosis are known indicators of a poor acute prognosis. However, there is a lack of data regarding the long-term arrhythmic impact of ventricular tachyarrhythmia (VA) on mortality in ACS patients. This study sought to elucidate the impact of tachyarrhythmia on mortality during long-term follow-up in patients with a history of ACS. This retrospective study was conducted in a single university hospital, and it evaluated the clinical outcomes, especially regarding cardiovascular mortality and readmission. The enrolled patients underwent percutaneous coronary intervention (PCI) for ACS between February 2004 and March 2018. Clinical information was attained by a thorough chart review. We retrospectively analyzed 560 ACS patients. We reviewed all electrocardiograms (ECGs) before and immediately after PCI, during hospitalization, and within 3 months of the index PCI. Three months after the index PCI procedure, any Holter monitoring or ECG was also reviewed for arrhythmia diagnosis. During follow-up, 91 patients were diagnosed with AF and 36 patients were diagnosed with VA. Overall mortality was related to the presence of anemia, low body mass index, low left ventricular ejection fraction after PCI, late-diagnosed AF, and any VA during follow-up. Readmission was higher in patients with chronic kidney disease and newly diagnosed AF during the follow-up. Diagnosis of late tachyarrhythmia during follow-up was associated with increased mortality in post-ACS patients.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Kaplan–Meier curve according to AF vs no AF. AF = atrial fibrillation.
Figure 2.
Figure 2.
Kaplan–Meier curve according to VA vs no VA. VA= ventricular arrhythmia.
See this image and copyright information in PMC

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