Álvarez-Álvarez Belén, Bouzas-Cruz Noelia, Abu-Assi Emad, Raposeiras-Roubin Sergio, López-López Andrea, González Cambeiro María Cristina, Peña-Gil Carlos, García-Acuña José María, González-Juanatey José Ramón
Servicio de Cardiología y Unidad Coronaria, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
Servicio de Cardiología y Unidad Coronaria, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
Rev Esp Cardiol (Engl Ed). 2015 Oct;68(10):878-84. doi: 10.1016/j.rec.2014.11.015. Epub 2015 Mar 21.
There is little information on the effect of acute coronary syndrome complicated by ventricular fibrillation on the long-term incidence of sudden cardiac death. We analyzed this effect in a contemporary cohort of patients with acute coronary syndrome.
We studied 5302 consecutive patients with acute coronary syndrome between December 2003 and December 2012. We compared mortality during and after hospitalization according to the presence or absence of ventricular fibrillation.
Ventricular fibrillation was observed in 163 (3.1%) patients, and was early onset in 72.4% of these patients. In-hospital mortality was 36.2% in the group with ventricular fibrillation and 4.7% in the group without (p<.001). After a mean follow-up of 4.7 years (standard deviation, 2.6 years), mortality was 30.7% in the ventricular fibrillation group and 24.7% in the other group (P=.23). After adjusting for confounding variables, the presence of ventricular fibrillation was not associated with an increased risk of death in the follow-up period (hazard ratio=1.29; 95% confidence interval, 0.90-1.87). The cause of death was established in 72% of patients. The incidence of sudden death was 12.9% in the ventricular fibrillation group and 11.9% in the other group (P=.71). Cardiovascular-cause mortality was also similar between the 2 groups (35.5% and 34.4%, respectively.
Patients with acute coronary syndrome complicated by ventricular fibrillation who survive the in-hospital phase do not appear to be at an increased risk of sudden cardiac death or other cardiovascular-cause death.
关于急性冠脉综合征并发心室颤动对心脏性猝死长期发生率的影响，相关信息较少。我们在当代急性冠脉综合征患者队列中分析了这种影响。
我们研究了2003年12月至2012年12月期间连续收治的5302例急性冠脉综合征患者。根据是否存在心室颤动比较住院期间及出院后的死亡率。
163例（3.1%）患者出现心室颤动，其中72.4%为早期发作。心室颤动组的院内死亡率为36.2%，无心室颤动组为4.7%（p<0.001）。平均随访4.7年（标准差2.6年）后，心室颤动组的死亡率为30.7%，另一组为24.7%（P=0.23）。在对混杂变量进行校正后，心室颤动的存在与随访期死亡风险增加无关（风险比=1.29；95%置信区间，0.90 - 1.87）。72%的患者确定了死因。心室颤动组的猝死发生率为12.9%，另一组为11.9%（P=0.71）。两组心血管病因死亡率也相似（分别为35.5%和34.4%）。
急性冠脉综合征并发心室颤动且存活至出院的患者，心脏性猝死或其他心血管病因死亡风险似乎并未增加。
