Abstract
Purpose:
of this study was to re-evaluate the association between ventricular arrhythmias and long-term mortality after acute myocardial infarction (AMI) in the thrombolytic era.
Methods:
MITRA (maximal individual therapy in patients with AMI) is a multicenter registry of 54 hospitals in Germany investigating patients with AMI.
Results:
2420 patients received Holter ECG. Positive Holter ECG was defined: > or =10 ventricular premature beats (VPB)/h, or > or =4 couplets/d, or > or =1 non-sustained ventricular tachycardia (nsusVT)/d, or their combination. Mortality rates (median 17 months) were 6.5% without ventricular arrhythmias, with > or =10 VPB/h 15.2% and with the combination of > or =10 VPB/h plus either > or =4 couplets/d or > or =1 nsusVT/d 23.4%. In multivariate analysis, none of the ventricular arrhythmias alone correlated with mortality. There was a significant association between mortality and the combination of > or =10 VPB/h plus > or =4 couplets/d (OR 2.3) or > or =10 VPB/h plus > or =1 nsusVT/d (OR 2.8).
Conclusion:
Non-sustained VTs are only associated with poor prognosis if combined with frequent VPBs.
Publication types
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Evaluation Study
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Multicenter Study
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Research Support, Non-U.S. Gov't
MeSH terms
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Adrenergic beta-Antagonists / therapeutic use
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Angiotensin-Converting Enzyme Inhibitors / therapeutic use
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Aspirin / therapeutic use
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Cause of Death
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Drug Therapy, Combination
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Electrocardiography, Ambulatory
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Female
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Follow-Up Studies
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Germany
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Heart Failure / diagnosis
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Heart Failure / mortality
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Heart Failure / physiopathology
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Humans
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Male
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Multivariate Analysis
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Myocardial Infarction / drug therapy*
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Myocardial Infarction / mortality
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Myocardial Infarction / physiopathology
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Myocardial Reperfusion Injury / diagnosis*
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Myocardial Reperfusion Injury / mortality
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Myocardial Reperfusion Injury / physiopathology
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Prognosis
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Prospective Studies
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Registries
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Survival Rate
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Tachycardia, Ventricular / diagnosis*
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Tachycardia, Ventricular / mortality
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Tachycardia, Ventricular / physiopathology
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Thrombolytic Therapy*
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Treatment Outcome
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Ventricular Premature Complexes / diagnosis*
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Ventricular Premature Complexes / mortality
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Ventricular Premature Complexes / physiopathology
Substances
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Adrenergic beta-Antagonists
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Angiotensin-Converting Enzyme Inhibitors
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Aspirin