Abstract 14549: Impact of Ventricular Fibrillation on In-Hospital Mortality and Long-Term Mortality After Myocardial Infarction: The FAST-MI Registry
Little data exists in the contemporary era on the impact of ventricular fibrillation (VF) at the acute stage of AMI on early and long-term outcomes. We analysed the impact of in-hospital VF on in-hospital mortality and 3-year survival in hospital survivors of the FAST-MI registry, which included patients hospitalized within 48 hours of onset of AMI in France in 2005. Overall, 3670 patients were included, of whom 75 (2.0%) developed VF. Patients with VF were younger (63±15 vs 67±14 years, p<0.001), had a higher GRACE risk score (166 ±45 vs 149±37, p<0.001), and had more frequently STEMI (73% vs 50%, p<0.001). They were more frequently current smokers (45% vs 29%, p=0.002). In-hospital death was 25% in patients with, vs 5% in those without VF (p<0.001). In logistic regression analyses including baseline characteristics and management variables, VF was independently associated with a major risk of in-hospital death (OR 6.16 [3.09-12.26]). In the 3463 hospital survivors, however, 3-year survival was 91% in patients with VF versus 82% in patients without VF (p=0.09). Cox multivariate analysis was used to determine predictors of 3-year mortality and covariates included age, sex, risk factors, comorbidities, type of AMI, CAD extent, use of PCI, use of CABG, in-hospital complications, and discharge medications. The adjusted HR for 3-year death in hospital survivors having developed VF initially was 0.49 (0.18-1.32), p=0.15. Even in patients not receiving beta-blockers at discharge (n=746), VF at the acute stage was not a predictor of higher 3-year mortality (HR 1.14 [0.15-8.80]).
Conclusion: Patients developing VF at the acute stage of AMI are at higher risk of in-hospital mortality. Beyond the acute phase, however, acute VF is not a marker of long-term mortality.
- © 2011 by American Heart Association, Inc.