Long-term risk of new-onset arrhythmia in ST-segment elevation myocardial infarction according to revascularization status
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Long-term risk of new-onset arrhythmia in ST-segment elevation myocardial infarction according to revascularization status. / Thomsen, Anna F.; Jøns, Christian; Jabbari, Reza; Jacobsen, Mia R.; Stampe, Niels Kjær; Butt, Jawad H.; Olsen, Niels Thue; Kelbæk, Henning; Torp-Pedersen, Christian; Fosbøl, Emil L.; Pedersen, Frants; Køber, Lars; Engstrøm, Thomas; Jacobsen, Peter Karl.
I: Europace, Bind 25, Nr. 3, 2023, s. 931-939.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Long-term risk of new-onset arrhythmia in ST-segment elevation myocardial infarction according to revascularization status
AU - Thomsen, Anna F.
AU - Jøns, Christian
AU - Jabbari, Reza
AU - Jacobsen, Mia R.
AU - Stampe, Niels Kjær
AU - Butt, Jawad H.
AU - Olsen, Niels Thue
AU - Kelbæk, Henning
AU - Torp-Pedersen, Christian
AU - Fosbøl, Emil L.
AU - Pedersen, Frants
AU - Køber, Lars
AU - Engstrøm, Thomas
AU - Jacobsen, Peter Karl
N1 - Publisher Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2023
Y1 - 2023
N2 - AIMS: Emerging data show that complete revascularization (CR) reduces cardiovascular death and recurrent myocardial infarction in ST-segment elevation myocardial infarction (STEMI). However, the influence of revascularization status on development of arrhythmia in the long-term post-STEMI phase is poorly described. We hypothesized that incomplete revascularization (ICR) compared with CR in STEMI is associated with an increased long-term risk of new-onset arrhythmia. METHODS AND RESULTS: Patients with STEMI treated with primary percutaneous coronary intervention (PPCI) at Copenhagen University Hospital, Rigshospitalet, Denmark, with CR or ICR were identified via the Eastern Danish Heart registry from 2009 to 2016. Using unique Danish administrative registries, the outcomes were assessed. The primary outcome was new-onset arrhythmia defined as a composite of atrial fibrillation/flutter (AF), sinoatrial block, advanced second- or third-degree atrioventricular block, ventricular tachycardia/fibrillation (VT), or cardiac arrest (CA), with presentation >7 days post-PPCI. Secondary outcomes were the components of the primary outcome and all-cause mortality. A total of 5103 patients (median age: 62.0 years; 76% men) were included, of whom 4009 (79%) and 1094 (21%) patients underwent CR and ICR, respectively. Compared with CR, ICR was associated with a higher risk of new-onset arrhythmia [hazard ratio (HR), 1.33; 95% confidence interval (CI), 1.07-1.66; P = 0.01], AF (HR, 1.29; 95% CI, 1.00-1.66; P = 0.05), a combined outcome of VT and CA (HR, 1.77; 95% CI, 1.10-2.84; P = 0.02) and all-cause mortality (HR, 1.27; 95% CI, 1.05-1.53; P = 0.01). All HRs adjusted. CONCLUSION: Among patients with STEMI, ICR was associated with an increased long-term risk of new-onset arrhythmia and all-cause mortality compared with CR.
AB - AIMS: Emerging data show that complete revascularization (CR) reduces cardiovascular death and recurrent myocardial infarction in ST-segment elevation myocardial infarction (STEMI). However, the influence of revascularization status on development of arrhythmia in the long-term post-STEMI phase is poorly described. We hypothesized that incomplete revascularization (ICR) compared with CR in STEMI is associated with an increased long-term risk of new-onset arrhythmia. METHODS AND RESULTS: Patients with STEMI treated with primary percutaneous coronary intervention (PPCI) at Copenhagen University Hospital, Rigshospitalet, Denmark, with CR or ICR were identified via the Eastern Danish Heart registry from 2009 to 2016. Using unique Danish administrative registries, the outcomes were assessed. The primary outcome was new-onset arrhythmia defined as a composite of atrial fibrillation/flutter (AF), sinoatrial block, advanced second- or third-degree atrioventricular block, ventricular tachycardia/fibrillation (VT), or cardiac arrest (CA), with presentation >7 days post-PPCI. Secondary outcomes were the components of the primary outcome and all-cause mortality. A total of 5103 patients (median age: 62.0 years; 76% men) were included, of whom 4009 (79%) and 1094 (21%) patients underwent CR and ICR, respectively. Compared with CR, ICR was associated with a higher risk of new-onset arrhythmia [hazard ratio (HR), 1.33; 95% confidence interval (CI), 1.07-1.66; P = 0.01], AF (HR, 1.29; 95% CI, 1.00-1.66; P = 0.05), a combined outcome of VT and CA (HR, 1.77; 95% CI, 1.10-2.84; P = 0.02) and all-cause mortality (HR, 1.27; 95% CI, 1.05-1.53; P = 0.01). All HRs adjusted. CONCLUSION: Among patients with STEMI, ICR was associated with an increased long-term risk of new-onset arrhythmia and all-cause mortality compared with CR.
KW - All-cause mortality
KW - Cardiac arrhythmia
KW - Complete revascularization
KW - Ischaemic heart disease
KW - Percutaneous coronary intervention
U2 - 10.1093/europace/euac242
DO - 10.1093/europace/euac242
M3 - Journal article
C2 - 36520640
AN - SCOPUS:85151573544
VL - 25
SP - 931
EP - 939
JO - Europace
JF - Europace
SN - 1099-5129
IS - 3
ER -
ID: 366522092